血清CEA与癌组织标本中TTF-1检测对肺腺癌EGFR突变的预测价值  

Predictive value of detection of CEA in serum and TTF-1 in cancer tissues for EGFR mutation in lung adenocarcinoma

作　　者：杨燕君[1] 董跃华[1] 张晓丽[1] 王贵刚[1] 姜伟华[1] 魏玉磊[1] 周义 高永山[1] Yang Yanjun;Dong Yuehua;Zhang Xiaoli;Wang Guigang;Jiang Weihua;Wei Yulei;Zhou Yi;Gao Yongshan(Department of Cardiothoracic Surgery,the First Affiliated Hospital of Hebei North University,Hebei Zhangjiakou 075000,China)

机构地区：[1]河北北方学院附属第一医院胸心外科,河北张家口075000

出　　处：《现代肿瘤医学》2020年第11期1870-1873,共4页Journal of Modern Oncology

基　　金：河北省医学科学研究课题计划(编号:20190907)。

摘　　要：目的:血清癌胚抗原(CEA)与癌组织标本中甲状腺转录因子-1(TTF-1)检测对肺腺癌表皮生长因子受体(EGFR)突变的预测价值。方法:选取2018年6月至2019年5月本院胸心外科住院部收治的92例经常规病理检查证实肺腺癌患者作为研究对象,根据突变特异性扩增系统(ARMS)聚合酶链反应(RT-PCR)方法检测EGFR突变结果分为EGFR突变组(n=55)和EGFR野生组(n=37),观察两组患者CEA、TTF-1表达情况,不同浓度CEA及与TTF-1联合对EGFR突变的预测价值。结果:EGFR突变组患者血清CEA水平、阳性率均明显高于EGFR野生组(P<0.05);EGFR突变组患者TTF-1阳性率为89.09%,高于EGFR野生组的13.51%(P<0.05);肺腺癌患者血清CEA水平≥5μg/L、≥20μg/L、≥50μg/L EGFR突变率高于<5μg/L患者(P<0.05),五组间EGFR突变率比较差异有统计学意义(P<0.05);血清CEA≥5μg/L对EGFR突变的敏感度、特异性较高;CEA≥5μg/L+TTF-1预测肺腺癌EGFR突变的敏感度、特异性、阳性预测值、阴性预测值、准确度最高。结论:肺腺癌EGFR突变患者血清CEA水平升高,TTF-1阳性率高,当CEA≥5μg/L且TTF-1阳性表达时对肺腺癌EGFR突变的预测率高。Objective:To investigate the predictive value of serum carcinoembryonic antigen(CEA)and thyroid transcription factor-1(TTF-1)detection in lung adenocarcinoma epidermal growth factor receptor(EGFR)mutation.Methods:Ninety-two patients with lung adenocarcinoma confirmed by routine pathological examination were selected from the department of cardiothoracic surgery of our hospital from June 2018 to May 2019.According to amplification refractory mutation system(ARMS)and reverse transcription-polymerase chain reaction(RT-PCR),the results of detecting EGFR mutation were divided into two groups:EGFR mutant group(n=55)and EGFR wild group(n=37).The expression of CEA and TTF-1 and the predictive values of different concentrations of CEA and its combination with TTF-1 in predicting EGFR mutation were observed.Results:The serum CEA level and positive rate of EGFR mutant group were significantly higher than those of EGFR wild group(P<0.05).The positive rate of TTF-1 in EGFR mutant group was 89.09%,which was higher than 13.51%in EGFR wild group(P<0.05).The mutation rate of EGFR of lung adenocarcinoma patients with serum CEA levels≥5μg/L,≥20μg/L,≥50μg/L was higher that in patients with<5μg/L(P<0.05),and there was significant difference in mutation rate of EGFR among the five groups(P<0.05).The sensitivity and specificity of serum CEA≥5μg/L were high for EGFR mutation.The sensitivity,specificity,positive predictive value,negative predictive value and accuracy of CEA≥5μg/L+TTF-1 in predicting EGFR mutation in lung adenocarcinoma were the highest.Conclusion:The serum CEA level of patients with EGFR mutation in lung adenocarcinoma is elevated,and TTF-1 positive rate is high.When CEA is≥5μg/L and TTF-1 shows positive expression,the prediction rate of EGFR mutation in lung adenocarcinoma is high.

关 键 词：肺腺癌 表皮生长因子受体 突变 癌胚抗原 甲状腺转录因子-1 预测价值 

分 类 号：R734.2[医药卫生—肿瘤]