临床肿瘤学杂志

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肺腺癌患者血清及胸水CEA与EGFR突变的相关性研究

吕艳玲1,袁冬梅2,宋勇2,金淑贤1

  

  1. 1 东南大学附属南京市第二医院呼吸内科 2 南京军区南京总医院呼吸内科
  • 收稿日期:2016-05-10 修回日期:2016-06-12 出版日期:2016-07-30 发布日期:2016-07-30
  • 通讯作者: 金淑贤

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

LV Yanling, YUAN Dongmei, SONG Yong, JIN Shuxian.   

  1. Department of Respiratory Medicine, the Second Hospital of Nanjing Affiliated to Southeast University
  • Received:2016-05-10 Revised:2016-06-12 Online:2016-07-30 Published:2016-07-30
  • Contact: JIN Shuxian

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-off 3组的EGFR突变率分别为64.3%、60.0%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。

Abstract: Objective To determine the expression of carcino embryonie antigen(CEA)in serum and pleural effusion in patients with lung adenocarcinoma and its relationship with epidermal growth factor receptor(EGFR)mutations. MethodsSeventynine serum and pleural effusion samples were collected from 79 lung adenocarcinoma patients with malignant pleural effusion. The concentration of CEA was detected by immunoradiometric assay, and the relationship between the level of CEA and EGFR mutations was analyzed. ResultsA 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 sensitivity 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 multivariate regression analysis, the level of pleural effusion CEA(HR: 1.002, 95% CI:1.001-1.004, P=0.003)was confirmed as independent factor of predicting EGFR mutations. Conclusion CEA can probably serve as a marker of predicting EGFR mutations.

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