癌胚抗原、甲状腺转录因子-1在评价表皮生长因子受体-酪氨酸激酶抑制剂治疗肺腺癌疗效和预后中的价值  

Value of carcinoembryonic antigen and thyroid transcription factor-1 in evaluation of the efficacy and prognosis in lung adenocarcinoma patients treated with epidermal growth factor receptor-tyrosine kinase inhibitor

作　　者：豆亚伟[1] 陈耀华[1] 田伟[1] 王宏涛[1] 吕珊珊 DOU Yawei;CHEN Yaohua;TIAN Wei;WANG Hongtao;LYU Shanshan(Department of Thoracic Surgery,Shaanxi Provincial People’s Hospital,Xi’an 710068,Shaanxi,China;Department of Cardiovascular Surgery,Xijing Hospital,the First Affiliated Hospital of the Fourth Military Medical University,Xi’an 710032,Shaanxi,China)

机构地区：[1]陕西省人民医院胸外科,西安710068 [2]空军军医大学第一附属医院西京医院心血管外科,西安7100320

出　　处：《癌症进展》2022年第11期1116-1120,共5页Oncology Progress

摘　　要：目的探讨血清癌胚抗原(CEA)、甲状腺转录因子-1(TTF-1)在评价表皮生长因子受体-酪氨酸激酶抑制剂(EGFR-TKI)治疗肺腺癌疗效和预后中的价值。方法收集158例肺腺癌患者的病历资料,所有患者均接受EGFR-TKI治疗。记录患者的临床疗效,比较治疗前后肺腺癌患者的CEA、TTF-1水平,比较治疗后疾病控制与疾病进展肺腺癌患者的CEA、TTF-1水平,采用Logistic回归模型分析EGFR-TKI治疗后肺腺癌患者预后的影响因素。结果EGFR-TKI治疗后4周,完全缓解4例(2.53%),部分缓解36例(22.78%),疾病稳定69例(43.67%),疾病进展49例(31.01%),客观缓解率为25.32%(40/158),疾病控制率为68.99%(109/158)。治疗后肺腺癌患者的CEA、TTF-1水平均明显低于治疗前,治疗后疾病控制肺腺癌患者的CEA、TTF-1水平均明显低于疾病进展患者,差异均有统计学意义(P﹤0.01)。158例患者均未失访,预后良好107例,预后不良51例。预后良好与预后不良肺腺癌患者的临床分期、肿瘤转移情况、CEA水平、TTF-1水平比较,差异均有统计学意义(P﹤0.05)。多因素分析结果显示,临床分期为Ⅳ期、肿瘤转移、CEA水平≥3.4 ng/ml、TTF-1水平≥13.6μg/L均是EGFR-TKI治疗后肺腺癌患者预后的独立危险因素(P﹤0.05)。结论CEA、TTF-1与肺腺癌患者EGFR-TKI治疗的临床疗效及预后有关,有可能成为判断疗效及预后的标志物。Objective To investigate the value of serum carcinoembryonic antigen(CEA)and thyroid transcription factor 1(TTF 1)in evaluation of the efficacy and prognosis in lung adenocarcinoma patients treated with epidermal growth factor receptor-tyrosine kinase inhibitor(EGFR-TKI).Method The medical data of 158 lung adenocarcinoma pa-tients who received EGFR-TKI therapy were collected.The clinical efficacy of the patients was recorded,the levels of CEA and TTF-1 in patients with lung adenocarcinoma before and after the treatment were compared,and the levels of CEA and TTF-1 in patients with lung adenocarcinoma with disease control and disease progression after treatment were also compared.The Logistic regression model was built to analyze the prognostic factors for lung adenocarcinoma pa-tients after EGFR-TKI treatment.Result Four weeks after receiving EGFR-TKI treatment,4 patients(2.53%)had com-plete response,36 patients(22.78%)had partial response,69 patients(43.67%)had stable disease,and 49 patients(31.01%)had progressive disease,the objective response rate was 25.32%(40/158),and the disease control rate was 68.99%(109/158).The levels of CEA and TTF-1 in patients with lung adenocarcinoma after treatment were significantly lower than those before treatment,and the levels of CEA and TTF-1 in patients with disease controll after treatment were significantly lower than those in patients with disease progression,the differences were statistically significant(P<0.01).None of the 158 patients were lost to follow-up,and among them,107 patients had good prognosis and 51 patients had poor prognosis.There were significant differences in clinical stage,tumor metastasis,CEA level,and TTF-1 level be-tween patients with good and poor prognosis(P<0.05).The results of multivariate analysis showed that clinical stage IV,tumor metastasis,CEA level≥3.4 ng/ml,and TTF-1 level≥13.6μg/L were all independent risk factors for the prognosis of lung adenocarcinoma patients after EGFR-TKI treatment(P<0.05).Conclusion CEA and TTF-1 are related

关 键 词：癌胚抗原 甲状腺转录因子-1 表皮生长因子受体-酪氨酸激酶抑制剂 肺腺癌 临床疗效 预后 

分 类 号：R734.2[医药卫生—肿瘤]