107例经EGFR-TKIs一线治疗的非小细胞肺癌患者血肿瘤标记物水平与疗效的关系  

Relationship between tumor marker levels and efficacy of EGFR-TKIs first-line treatment in non-small cell lung cancer patients

作　　者：张岩巍[1] 刘友如[1] 张雪艳[1] 韩宝惠[1] 

机构地区：[1]上海交通大学附属胸科医院肺内科,上海200030

出　　处：《第三军医大学学报》2012年第20期2051-2055,共5页Journal of Third Military Medical University

摘　　要：目的探讨107例经EGFR-TKIs一线治疗的晚期非小细胞肺癌(non-small cell lung cancer,NSCLC)患者血肿瘤标记物水平与疗效的关系。方法 2008-2011年共107例NSCLC患者接受EGFR-TKIs的一线治疗,并在治疗前进行了血肿瘤标记物的检测。根据检查结果分为高表达组和低表达组,观察两组近期疗效,并进行相关性分析。结果 CEA≥5 ng/ml的患者EGFR-TKIs治疗有效率为23.4%(15/64),疾病控制率为70.3%(45/64),CEA<5 ng/ml的患者有效率为15.0%(6/40),疾病控制率为47.5%(19/40),疗效差异有统计学意义(P<0.05);CEA高表达患者PFS与CEA低表达患者相比差异无统计学意义(5.7个月vs 7.3个月,P=0.220)。其余的血肿瘤指标包括CA125、NSE、SCC及CYFRA21-1高表达组与低表达组之间DCR、ORR及PFS差异无统计学意义(P>0.05)。进一步分析了CEA高表达组和低表达组患者的一般临床特征,结果显示两组患者差异无统计学意义(P>0.05)。结论血清CEA水平可作为预测EGFR-TKIs治疗疗效的指标,与PFS关系并不确定。Objective Epidermal growth factor receptor tyrosine kinase inhibitors（EGFR-TKIs） have been widely used in the first-line treatment of non-small cell lung cancer（NSCLC） patients.Now the main prognosis target is EGFR mutation state.But some patients,EGFR mutation testing can not be performed for their pathological tissue,and their general conditions can not afford chemotherapy either.So we need more the clinical targets to predict the efficacy of EGFR-TKIs treatment.In this study,we investigated the relationship between serum levels of tumor markers and their therapeutic effect on advanced NSCLC patients treated with EGFR-TKIs as first-line treatment.Methods We retrospectively reviewed the clinical data of 107 NSCLC patients with EGFR-TKIs as first line therapy int our department between 2008 and 2011.All cases had a complete outcome of tumor markers.The statistical test between serum levels of tumor markers and therapeutic effects were performed by SPSS 13.0.Results In the group where serum level of carcino-embryonic antigen（CEA） 5 ng/ml,the effect rate was 15% and disease control rate（DCR） was 47.5%.In the patients whose serum level of CEA was ≥5 ng/ml,the effect rate was 23.4% and disease control rate was 70.3%.There was no statistical difference in progression-free survival（PFS） between the 2 groups（5.7 vs 7.3 months,P = 0.220）.For the other tumor markers,including carbohydrate antigen125（CA125）,neuron-specific enolase（NSE）,squamous cell carcinoma antigen（SCC） and cytokeratin-19-fragment CYFRA21-1,there was no statistical difference in PFS,DCR and objective response rate（ORR） between the elevated group and the normal group.There was also no significant difference in the clinicopathological characteristics between the patients with high and low levels of CEA.Conclusion Serum CEA level might be a predictive factor for the efficacy of EGFR-TKIs treatment.The relationship between the serum level of CEA and PFS is uncertain.

关 键 词：非小细胞肺癌 血肿瘤标记物 EGFR-TKIS 

分 类 号：R181.32[医药卫生—流行病学] R734.2[医药卫生—公共卫生与预防医学]