Correlation between EGFR gene mutation, cytologic tumor markers, 18F-FDG uptake in non-small cell lung cancer.
Correlation between EGFR gene mutation, cytologic tumor markers, 18F-FDG uptake in non-small cell lung cancer.
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DOI：
10.1186/s12885-016-2251-z
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发表时间：
2016-03-16
期刊：
影响因子：
3.8
通讯作者：
Choi BW
中科院分区：
文献类型：
--
作者：
Cho A;Hur J;Moon YW;Hong SR;Suh YJ;Kim YJ;Im DJ;Hong YJ;Lee HJ;Kim YJ;Shim HS;Lee JS;Kim JH;Choi BW
EGFR突变诱导的细胞增殖引起肿瘤生物学和肿瘤代谢的变化，这可能反映PET/CT上的肿瘤标志物浓度和18F-FDG摄取。原发性肺肿瘤的直接抽吸物含有与血清肿瘤标志物不同浓度的肿瘤标志物，并且与EGFR突变的相关性可能比血清肿瘤标志物更好。本研究旨在探讨非小细胞肺癌（NSCLC）细胞学肿瘤标志物和FDG摄取与EGFR突变状态之间的关系。我们前瞻性收集了61例接受EGFR突变分析的患者的肿瘤抽吸物。测量血清和细胞学CYFRA 21-1、CEA和SCCA水平，并与EGFR基因突变相关。对58例NSCLC患者进行FDG PET/CT分期，SUV与EGFR突变状态相关。30例（50%）患者有EGFR突变，57例患者有腺癌亚型。单因素分析显示，女性、从不吸烟、高细胞学CYFRA 21-1（c-CYFRA）水平和低最大标准摄取值（SUVmax）与EGFR突变相关。ROC产生的c-CYFRA的截止值为20.8 ng/ml，SUVmax为9.6，显示EGFR突变检测的最高灵敏度。多变量分析显示，女性性别[风险比（HR）：18.15，p = 0.025]、较高水平的c-CYFRA（HR：7.58）和较低的SUVmax（HR：0.08，p = 0.005）可预测携带EGFR突变。细胞学肿瘤标志物c-CYFRA与NSCLC中EGFR突变呈正相关。EGFR突变阳性的NSCLC与无EGFR突变的NSCLC相比具有相对较低的糖酵解。
EGFR mutation-induced cell proliferation causes changes in tumor biology and tumor metabolism, which may reflect tumor marker concentration and 18F-FDG uptake on PET/CT. Direct aspirates of primary lung tumors contain different concentrations of tumor markers than serum tumor markers, and may correlate better with EGFR mutation than serum tumor markers. The purpose of this study is to investigate an association between cytologic tumor markers and FDG uptake with EGFR mutation status in non-small cell lung cancer (NSCLC). We prospectively collected tumor aspirates of 61 patients who underwent EGFR mutation analysis. Serum and cytologic CYFRA 21-1, CEA, and SCCA levels were measured and correlated with EGFR gene mutations. FDG PET/CT was performed on 58 patients for NSCLC staging, and SUV was correlated with EGFR mutation status. Thirty (50 %) patients had EGFR mutation and 57 patients had adenocarcinoma subtype. Univariate analysis showed that female gender, never smoker, high levels of cytologic CYFRA 21-1 (c-CYFRA) and lower maximum standard uptake value (SUVmax) were correlated with EGFR mutations. ROC generated cut-off values of 20.8 ng/ml for c-CYFRA and SUVmax of 9.6 showed highest sensitivity for EGFR mutation detection. Multivariate analysis revealed that female gender [hazard ratio (HR): 18.15, p = 0.025], higher levels of c-CYFRA (HR: 7.58, and lower SUVmax (HR: 0.08, p = 0.005) were predictive of harboring EGFR mutation. The cytologic tumor marker c-CYFRA was positively associated with EGFR mutations in NSCLC. EGFR mutation-positive NSCLCs have relatively lower glycolysis compared with NSCLCs without EGFR mutation.