非小细胞肺癌患者EGFR基因突变与血清肿瘤标志物之间关系探讨

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摘要目的：分析非小细胞肺癌（NSCLC）患者表皮生长因子受体（EGFR）基因突变与血清肿瘤标志物之间的关系，探讨可预测EGFR基因突变的肿瘤标志物。方法：回顾性分析2010年10月至2013年8月在我院经病理确诊为NSCLC的188例患者的临床资料，所有患者进行EGFR基因突变检测并在治疗前2周内完成血清肿瘤标志物的检测。对EGFR基因突变与患者的临床基本特征及血清肿瘤标志物之间的关系进行统计学分析。结果：本研究中NSCLC患者的EGFR基因突变率为44.7%。EGFR基因突变多发生于女性、非吸烟及肺腺癌患者（P＜0.05），而与患者的年龄及肿瘤分期无明显相关性（P＞0.05）。当血清癌胚抗原（CEA）＞20μg/L
时，EGFR基因突变率明显升高；血清鳞状细胞癌抗原（SCCAg）≤1.5μg/L时，EGFR基因突变率也明显升高。其中，SCCAg≤1.5μg/L且CEA＞20μg/L组与SCCAg≤1.5μg/L或CEA＞20μg/L组，SCCAg＞1.5μg/L且CEA≤20μg/L组相比，EGFR突变率最高，差异有统计学意义（P＜0.05）。未发现其他血清肿瘤标志物如细胞角蛋白（CYFRA）21-1、神经元特异性烯醇化酶（NSE）、CA125和CA199在EGFR基因突变型和野生型中的差异（P＞0.05）。结论：EGFR基因突变主要发生于女性、非吸烟及肺腺癌患者。在无法进行EGFR基因突变检测的患者中，我们可以选择血清SCCAg≤1.5μg/L且CEA＞20μg/L的患者，结合临床优势人群，经验性使用表皮生长因子受体酪氨酸激酶抑制剂（EGFR-TKIs）治疗。

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	蒲桂梅1
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	叶君如1
	卢瑶1
	陈必成2
	欧阳金生1
	李玉苹1

关键词 ：癌, 非小细胞肺, 受体, 表皮生长因子, 基因突变, 肿瘤标志物

Abstract：Objective: To analyze the relationship between EGFR gene mutation and serum tumor markers in non-small cell lung cancer (NSCLC) patients and investigate the tumor markers that can predict the EGFR gene mutation. Methods: Retrospectively analyze of 188 NSCLC patients’ clinical characteristic in our hospital, who were detected EGFR gene mutation from October 2010 to August 2013. All the patients tested the serum tumor markers before treatment. Statistical methods were used to analyze the relationship between EGFR gene mutation and basic clinical characteristics and serum tumor markers. Results: 188 NSCLC patients were enrolled, and mutation rate was 44.7 percent. EGFR gene mutation was mainly occurred in women, non-smoking and adenocarcinoma patients (P<0.05). When the serum CEA>20 μg/L, or the serum SCCAg≤1.5 μg/L, EGFR mutation rate was significantly increased. Most importantly, EGFR mutation rate was highest when SCCAg≤1.5 μg/L and CEA>20 μg/L group, and the difference was statistically significant (P<0.05). While there was no correlation between CYFRA21-1, NSE, CA125, CA199 and EGFR gene mutation (P>0.05). Conclusion: For the patients whose EGFR gene mutation can not be tested, we can chose those whose serum SCCAg≤1.5 μg/L and CEA>20 μg/L, and according to the patients’ clinical characteristic, with EGFR-TKIs treatment.

Key words： carcinoma, non-small cell lung receptor, epidermal growth factor tyrosine gene mutation tumor markers

收稿日期: 2014-03-17

通讯作者: 李玉苹，教授，主任医师，硕士生导师，Email：wzliyp@163.com

作者简介: 蒲桂梅（1987-），女，浙江上虞人，硕士生。

链接本文:

https://xb.wmu.edu.cn/CN/ 或 https://xb.wmu.edu.cn/CN/Y2014/V44/I9/667

[1]Siegel R, Naishadham D, Jemal A. Cancer statistics, 2013[J].CA Cancer J Clin, 2013, 63(1): 11-30.
[2]Hirata H, Nakamura K, Kunitake N, et al. Association be-tween EGFR-TKI resistance and efficacy of radiotherapy for brain metastases from EGFR-mutant lung adenocarcinoma[J]. Anticancer Res, 2013, 33(4): 1649-1655.
[3]Mitsudomi T, Morita S, Yatabe Y, et al. Gefitinib versus cis-platin plus docetaxel in patients with non-small-cell lung cancer harbouring mutations of the epidermal growth factor receptor(WJTOG3405): an open label, randomised phase 3 trial[J]. Lancet Oncol, 2010, 11(2): 121-128.
[4]Pallis AG, Syrigos KN. Epidermal growth factor receptor ty-rosine kinase inhibitors in the treatment of NSCLC[J]. Lung Cancer, 2013, 80(2): 120-130.
[5]钱小英, 叶环, 施肖红, 等. 肺癌患者外周血癌胚抗原、糖类抗原水平与肺癌分期、转移及预后的关系[J]. 温州医学院学报, 2008, 38(5): 264-266.
[6]Shoji F, Yoshino I, Yano T, et al. Serum carcinoembryon-ic antigen level is associated with epidermal growth factor receptor mutations in recurrent lung adenocarcinomas[J].Cancer, 2007, 110(12): 2793-2798.
[7]Okamoto T, Nakamura T, Ikeda J, et al. Serum carcino-embryonic antigen as a predictive marker for sensitivity to gefitinib in advanced non-small cell lung cancer[J]. Eur J Cancer, 2005, 41(9): 1286-1290.
[8]Zornosa C, Vandergrift JL, Kalemkerian GP, et al. First-Line Systemic therapy practice patterns and concordance with NCCN guidelines for patients diagnosed with metastatic NSCLC treated at NCCN institutions[J]. J Natl Compr Canc Netw, 2012, 10(7): 847-856.
[9]Shigematsu H, Lin L, Takahashi T, et al. Clinical and biolog-ical features associated with epidermal growth factor recep-tor gene mutations in lung cancers[J]. J Natl Cancer Inst, 2005, 97(5): 339-346.
[10]徐琳, 郑明峰, 张稷, 等. EGFR突变基因检测与肿瘤指标相关性研究[J]. 医学研究杂志, 2011, 40(8): 79-81.
[11]Pan JB, Hou YH, Zhang GJ. Correlation between EGFR mutations and serum tumor markers in lung adenocarcinoma patients[J]. Asian Pac J Cancer Prev, 2013, 14(2): 695-700.
[12]Petra S, Rudof H, Stefan H, et a1. National academy of clin-ical biochemistry guidelines and recommendations for use of tumor markers in lung cancer. (Section 3P)[EB/OL].http://www.aacc.org/SiteCollectionDocuments/NACB/LMPG/tumor/chp3p_lung.pdf.
[13]Travis WD, Rekhtman N, Riley GJ, et al. Pathologic diagno-sis of advanced lung cancer based on small biopsies and cytology:a paradigm shift[J]. J Thorac Oncol, 2010, 5(4): 411-414.
[14]Tanaka K, Hata A, Kaji R, et al. Cytokeratin 19 fragment predicts the efficacy of epidermal growth factor receptor-ty-rosine kinase inhibitor in non-small-cell lung cancer harbor-ing EGFR mutation[J]. J Thorac Oncol, 2013, 8(7): 892-898.