癌胚抗原对肺癌患者基因突变状况的预测价值  

Predictive Value of CEA for Gene Mutations in Patients with Lung Cancer

作　　者：张红军[1] 房延凤[1] 苏尉 谢永宏[1] 金发光[1] 顾兴[1] ZHANG Hongjun;FANG Yanfeng;SU Wei;XIE Yonghong;JIN Faguang;GU Xing(Department of Respiratory Disease, Tangdu Hospital, the Fourth Military Medical University, Xi’an, Shannxi, 710038, China)

机构地区：[1]第四军医大学唐都医院呼吸内科,陕西西安710038

出　　处：《肿瘤药学》2017年第5期545-550,共6页Anti-Tumor Pharmacy

基　　金：国家自然科学基金资助(81071933)

摘　　要：目的通过回顾性分析肺癌患者癌胚抗原(CEA)、铁蛋白(FRT)、糖类抗原125(CA125)、神经元特异性烯醇化酶(NSE)和细胞角蛋白19片段(CYFRA21-1)五种血清肿瘤标志物(TM)水平,探讨不同TM对肺癌患者基因突变状况的预测价值。方法分别采用电化学发光免疫分析法和探针扩增阻滞突变系统聚合酶链反应法检测唐都医院呼吸内科经治的134例肺癌患者的5种血清学TM水平及基因突变状况,分析TM水平与基因突变状况之间的关系。结果基因突变的肺癌患者CEA和NSE均高于无基因突变的肺癌患者(P<0.01,P=0.034)。血清CEA和NSE预测基因突变的曲线下面积(AUC)分别为0.727(95%CI:0.634~0.820)、0.615(95%CI:0.510~0.721)。血清CEA≥13.81 ng·m L-1和NSE≥17.57 ng·m L-1的肺癌患者基因突变率明显增高(P<0.05)。血清CEA<3.4 ng·m L-1、3.4~13.81 ng·m L-1、13.81~41.02 ng·m L-1和>41.02 ng·m L-1肺癌患者的基因突变率分别是16.28%、15.79%、52.17%和55.17%,基因突变率有随CEA水平逐渐增高的趋势(P=0.001)。结论血清CEA和NSE水平对肺癌患者的基因突变状况具有预测价值,血清CEA预测价值可能更优于血清NSE。Objective To investigate the Levels of the carcino-embryonic antigen(CEA),ferritin(FRT),carbohydrate antigen125(CA125),neuron-specific enolase(NSE)and cytokeratin19fragments(CYFRA21-1)and mutations in patients with lung cancer andto explore their predictive value of different tumor markers(TM)in patients with lung cancer for their mutations.Methods In this study,134patients with lung cancer were recruited in department of respiratory medicine of Tangdu Hospital.CEA,FRT,CA125,NSE and CYFRA21-1were measured by Electro-Chemiluminescence Immunoassay(ECLI).And their mutations were measured by amplification refractorymutation system(ARMS).Then the relations between the level of TM and mutations were analyzed.Results The levels of CEA andNSE were significantly higher in lung cancer patients with mutations than in those without mutations(P<0.001and P=0.034,respectively),the area under curve(AUC)for CEA and NSE were0.727(95%CI:0.634～0.820)and0.615(95%CI:0.510～0.721)respectively.Whenthe cut-off values of CEA≥13.81ng·mL-1and NSE≥17.57ng·mL-1respectively,the rate of mutation in lung patients increased obviously(P<0.05).Moreover,the positive rates of mutations in lung cancer patients with CEA<3.4ng·mL-1,3.4～13.81ng·mL-1,13.81～41.02ng·mL-1and>41.02ng·mL-1were respectively16.28%,15.79%,52.17%and55.17%(P=0.001).The mutation rate of lung patients trendedto increase along with the rise of CEA level.Conclusion Both serum CEA and NSE could serve as prediction markers of mutations in patientswith lung cancer,and serum CEA may have better predictive ability than serum NSE.

关 键 词：肺癌 癌胚抗原 基因突变 

分 类 号：R734.2[医药卫生—肿瘤]