非小细胞肺癌患者EGFR基因突变与血清肿瘤标志物之间关系探讨  

The relationship between EGFR gene mutation and serum tumor markers in non-small cell lung cancer patients

作　　者：蒲桂梅 叶君如[1] 卢瑶[1] 陈必成[3] 欧阳金生[1] 李玉苹[1] 

机构地区：[1]温州医科大学附属第一医院呼吸内科,浙江温州325015 [2]绍兴市人民医院呼吸内科,浙江绍兴312000 [3]温州医科大学附属第一医院外科实验中心,浙江温州325015

出　　处：《温州医学院学报》2014年第9期667-671,共5页Journal of Wenzhou Medical College

摘　　要：目的:分析非小细胞肺癌(NSCLC)患者表皮生长因子受体(EGFR)基因突变与血清肿瘤标志物之间的关系,探讨可预测EGFR基因突变的肿瘤标志物。方法:回顾性分析2010年10月至2013年8月在我院经病理确诊为NSCLC的188例患者的临床资料,所有患者进行EGFR基因突变检测并在治疗前2周内完成血清肿瘤标志物的检测。对EGFR基因突变与患者的临床基本特征及血清肿瘤标志物之间的关系进行统计学分析。结果:本研究中NSCLC患者的EGFR基因突变率为44.7%。EGFR基因突变多发生于女性、非吸烟及肺腺癌患者(P<0.05),而与患者的年龄及肿瘤分期无明显相关性(P>0.05)。当血清癌胚抗原(CEA)>20μg/L时,EGFR基因突变率明显升高;血清鳞状细胞癌抗原(SCCAg)≤1.5μg/L时,EGFR基因突变率也明显升高。其中,SCCAg≤1.5μg/L且CEA>20μg/L组与SCCAg≤1.5μg/L或CEA>20μg/L组,SCCAg>1.5μg/L且CEA≤20μg/L组相比,EGFR突变率最高,差异有统计学意义(P<0.05)。未发现其他血清肿瘤标志物如细胞角蛋白(CYFRA)21-1、神经元特异性烯醇化酶(NSE)、CA125和CA199在EGFR基因突变型和野生型中的差异(P>0.05)。结论:EGFR基因突变主要发生于女性、非吸烟及肺腺癌患者。在无法进行EGFR基因突变检测的患者中,我们可以选择血清SCCAg≤1.5μg/L且CEA>20μg/L的患者,结合临床优势人群,经验性使用表皮生长因子受体酪氨酸激酶抑制剂(EGFR-TKIs)治疗。Objective：To analyze the relationship between EGFR gene mutation and serum tumor mark-ers in non-small cell lung cancer （NSCLC） patients and investigate the tumor markers that can predict the EGFR gene mutation. MethodRetrospectively analyze of 188 NSCLC patients’ clinical characteristic in our hospital, who were detected EGFR gene mutation from October 2010 to August 2013. All the patients tested the serum tumor markers before treatment. Statistical methods were used to analyze the relationship between EGFR gene mutation and basic clinical characteristics and serum tumor markers. Result188 NSCLC patients were en-rolled, and mutation rate was 44.7 percent. EGFR gene mutation was mainly occurred in women, non-smoking and adenocarcinoma patients （P＆lt;0.05）. When the serum CEA＆gt;20μg/L, or the serum SCCAg≤1.5μg/L, EGFR mutation rate was signiifcantly increased. Most importantly, EGFR mutation rate was highest when SCCAg≤1.5μg/L and CEA＆gt;20μg/L group, and the difference was statistically signiifcant （P＆lt;0.05）. While there was no cor-relation between CYFRA21-1, NSE, CA125, CA199 and EGFR gene mutation （P＆gt;0.05）. Conclusion：For the patients whose EGFR gene mutation can not be tested, we can chose those whose serum SCCAg≤1.5μg/L and CEA＆gt;20μg/L, and according to the patients’ clinical characteristic, with EGFR-TKIs treatment.

关 键 词：癌 非小细胞肺 受体 表皮生长因子 基因突变 肿瘤标志物 

分 类 号：R563[医药卫生—呼吸系统]