Analysis of CEA Expression and EGFR Mutation Status in Non-small Cell Lung Cancers
Analysis of CEA Expression and EGFR Mutation Status in Non-small Cell Lung Cancers
复制标题
DOI：
10.7314/apjcp.2014.15.8.3451
复制
发表时间：
2014-01-01
影响因子：
--
通讯作者：
Liu, Ting
中科院分区：
文献类型：
--
作者：
Yang, Zhong-Ming;Ding, Xian-Ping;Liu, Ting
背景：血清癌胚抗原（CEA）水平可反映肿瘤的生长、复发和转移。已有研究报道，表皮生长因子受体（EGFR）外显子19和21突变可能与肿瘤细胞对EGFR-TKI治疗的敏感性有重要关系。本研究旨在探讨EGFR突变和血清CEA在非小细胞肺癌（NSCLC）患者中的临床价值。材料与方法：采用实时荧光PCR技术检测315例NSCLC患者组织标本中EGFR第19、21外显子突变情况，采用电化学发光法检测未行手术、放疗、化疗及靶向治疗患者血清CEA水平。结果：EGFR基因第19、21外显子突变率分别为23.2%、14.9%，两者联合突变率为3.81%。在手术、放疗、化疗和靶向治疗开始前测量，54.3%的患者血清CEA水平异常高。血清CEA ≥ 20 ng/mL者，阳性率分别为36.4%和62.5%。此外，在CEA水平为20 - 49 ng/mL的患者队列中，EGFR突变率为85.7%，而在CEA水平>= 50 ng/mL的患者队列中，EGFR突变率仅为20.0%，与CEA水平= 20 ng/mL的病例大致相同，尤其是20 - 49 ng/mL的患者。如果患者样本不适合EGFR突变检测，或根本无法获得，检测血清CEA水平可能是一种简单易行的筛查方法。因此，对于血清CEA水平较高（>= 20 ng/mL，尤其是20 ng/mL与49 ng/mL相近）的NSCLC患者，值得尝试EGFR-TKI治疗，可能获得更好的临床疗效和生活质量。
Background: The serum carcinoembryonic antigen (CEA) level can reflect tumor growth, recurrence and metastasis. It has been reported that epidermal growth factor receptor (EGFR) mutations in exons 19 and 21 may have an important relationship with tumor cell sensitivity to EGFR-TKI therapy. In this study, we investigated the clinical value of EGFR mutations and serum CEA in patients with non-small cell lung cancer (NSCLC). Materials and Methods: The presence of mutations in EGFR exons 19 and 21 in the tissue samples of 315 patients with NSCLC was detected with real-time fluorescent PCR technology, while the serum CEA level in cases who had not yet undergone surgery, radiotherapy, chemotherapy and targeted therapy were assessed by electrochemical luminescence. Results: The mutation rates in EGFR exons 19 and 21 were 23.2% and 14.9%, respectively, with the two combined in 3.81%. Measured prior to the start of surgery, radiotherapy, chemotherapy and targeted treatment, serum CEA levels were abnormally high in 54.3% of the patients. In those with a serum CEA level = 20 ng/mL, the rates were 36.4% and 62.5%. In addition, in the cohort of patients with the CEA level being 20 similar to 49 ng/mL, the EGFR mutation rate was 85.7%, while in those with the CEA level >= 50 ng/mL, the EGFR mutation rate was only 20.0%, approximately the same as in cases with the CEA level= 20 ng/mL, especially 20 similar to 49 ng/mL). If patient samples are not suitable for EGFR mutation testing, or cannot be obtained at all, testing serum CEA levels might be a simple and easy screening method. Hence, for the NSCLC patients with high serum CEA level (>= 20 ng/mL, especially 20 similar to 49 ng/mL), it is worthy of attempting EGFR-TKI treatment, which may achieve better clinical efficacy and quality of life.