肺腺癌患者血清及胸水CEA与EGFR突变的相关性研究  

Clinical value of CEA in patients with lung adenocarcinoma and its relationship with epidermal growth factor receptor mutations

作　　者：吕艳玲[1] 袁冬梅[2] 宋勇[2] 金淑贤[3] 

机构地区：[1]东南大学附属南京市第二医院呼吸内科,南京210003 [2]南京军区南京总医院呼吸内科,210002 [3]南京医科大学第一附属医院呼吸内科,210029

出　　处：《临床肿瘤学杂志》2016年第7期621-625,共5页Chinese Clinical Oncology

基　　金：江苏省自然科学基金资助项目(BK20140736)

摘　　要：目的 探讨肺腺癌患者癌胚抗原（CEA）的表达水平与表皮生长因子受体（EGFR）突变的相关性。方法 检测79例肺腺癌患者血清及胸水CEA水平,并分析其表达与EGFR突变的关系。结果 79例患者均行EGFR检测,突变率为44.3%（35/79）。血清及胸水CEA水平预测EGFR突变的曲线下面积（AUC）分别为0.661（95%CI：0.536-0.785）、0.757（95%CI：0.653-0.862）。血清CEA≥19.5 ng/ml及胸水CEA≥55.5 ng/ml的患者EGFR基因突变率高（P〈0.05）。血清及胸水CEA均≥最佳截取值（Cut-off）、任一者≥Cut-off、两者均〈Cut-off3组的EGFR突变率分别为64．3％、60．O％和16．1％，差异有统计学意义（P〈0．001）。Logistic回归分析发现胸水CEA水平是预测EGFR基因突变的独立因素（OR：1．002，95％CI：1．001-1．004，P=0．003）。结论胸水及血清CEA水平可能作为预测EGFR突变的指标，胸水CEA数值可能更优于血清CEA。Objective To determine the expression of carcino embryonie antigen（ CEA） in serum and pleural effusion in pa-tients with lung adenocarcinoma and its relationship with epidermal growth factor receptor（ EGFR） mutations. Methods Seventy-nine serum and pleural effusion samples were collected from 79 lung adenocarcinoma patients with malignant pleural effusion. The concentra-tion of CEA was detected by immunoradiometric assay, and the relationship between the level of CEA and EGFR mutations was ana-lyzed. Results A total of 35 cases involved EGFR mutations, and the mutation rate of EGFR was 44. 3%（35/79）. For the serum CEA, the area under curve（ AUC） was 0. 661（ 95%CI：0. 536-0. 785） . When the cut-off value was 19. 5 ng/ml, the efficacy of sensi-tivity and specificity were best. For the pleural effusion CEA, when the cut-off value was 55. 5 ng/ml, the AUC was 0. 757（ 95%CI：0. 653-0. 862） . The mutation rate was significantly higher in the patients with high serum（≥19. 5 ng/ml） and pleural effusion（≥55. 5 ng/ml）levels of CEA than those with low expression levels（P〈0. 05）. Moreover, the positive rates of EGFR mutations of the three groups（ both≥cut-off, any of them≥cut-off and both〈cut-off） were 64. 3%, 60. 0%,16. 1%, respectively（ P〈0. 001） . In a multivari-ate regression analysis, the level of pleural effusion CEA（ HR：1. 002, 95% CI：1. 001-1. 004, P=0. 003） was confirmed as independ-ent factor of predicting EGFR mutations. Conclusion CEA can probably serve as a marker of predicting EGFR mutations.

关 键 词：肺腺癌 胸水 血清 癌胚抗原 表皮生长因子受体突变 

分 类 号：R734.2[医药卫生—肿瘤]