Predictive and prognostic value of preoperative serum tumor markers is EGFR mutation-specific in resectable non-small-cell lung cancer.
Predictive and prognostic value of preoperative serum tumor markers is EGFR mutation-specific in resectable non-small-cell lung cancer.
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术前血清肿瘤标志物对可切除非小细胞肺癌中 EGFR 突变特异性的预测和预后价值
DOI：
10.18632/oncotarget.8662
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发表时间：
2016-05-03
期刊：
影响因子：
--
通讯作者：
Li K
中科院分区：
文献类型：
--
作者：
Jiang R;Wang X;Li K
背景研究癌胚抗原(CEA)、细胞角蛋白-19片段(CyFRA21-1)、鳞状细胞癌抗原(SCCA)和神经元特异性烯醇化酶(NSE)在非小细胞肺癌(NSCLC)患者中的预测和预后价值。然而，很少有研究直接关注这些标志物与表皮生长因子受体(EGFR)突变状态或突变亚型之间的关系。患者和方法我们回顾分析了2008-2012年间接受完全切除的1016例I-IIIA期非小细胞肺癌患者。分析血清肿瘤标记物水平与EGFR突变及生存参数的相关性，确定影响预后的因素。结果在EGFR基因突变的腺癌患者中，CYFRA21-1水平(无瘤生存期P=0.032；总生存期P<=0.001)和临床分期是独立的预测和预后因素。CEA水平(P<；DFS为0.001；OS为P=0.002)和临床分期是EGFR野生型腺癌患者的独立预测和预后因素。进一步的分层分析显示，在EGFR19外显子缺失的腺癌中，CYFRA21-1升高是一个独立的预后因素(P=0.002)。在Leu858Arg替换亚组中，CEA升高(P=0.005)和临床分期是DFS的预测因素，CEA升高(P=0.005)和CYFRA21-1(P=0.027)是独立的预后因素。结论CYFRA21-1和CEA在EGFR突变的腺癌和野生型腺癌以及EGFR突变亚型之间具有不同的预测和预后价值。术前血清肿瘤标志物对预后的影响应与EGFR突变状态一起评估。
Background The predictive and prognostic value of carcinoembryonic antigen (CEA), cytokeratin-19 fragments (Cyfra21-1), squamous cell carcinoma antigen (SCCA) and neuron-specific enolase (NSE) has been investigated in non-small-cell lung cancer (NSCLC) patients. However, few studies have directly focused on the association between these markers and epidermal growth factor receptor (EGFR) mutation status or mutation subtypes. Patients and methods We retrospectively analyzed 1016 patients with stage I-IIIA NSCLC who underwent complete resection between 2008 and 2012. Correlations between serum tumor marker levels and EGFR mutations and survival parameters were analyzed and prognostic factors were identified. Results Cyfra21-1 levels (P = 0.032 for disease-free survival [DFS]; P < 0.001 for overall survival [OS]) and clinical stage were identified as independent predictive and prognostic factors in EGFR-mutated adenocarcinoma patients. CEA levels (P < 0.001 for DFS; P = 0.002 for OS) and clinical stage were independently predictive and prognostic in EGFR wild-type adenocarcinoma patients. Further stratification analysis revealed that in EGFR exon 19 deletion adenocarcinomas, elevated Cyfra21-1 was an independent prognostic factor (P = 0.002). Within the Leu858Arg substitution subgroup, increased CEA (P = 0.005) and clinical stage were predictive factors of DFS, while elevated CEA (P = 0.005) and Cyfra21-1 (P = 0.027) were independent prognostic factors. Conclusion Cyfra21-1 and CEA exhibit different predictive and prognostic values between EGFR-mutated and wild-type adenocarcinomas, as well as between EGFR mutation subtypes. The prognostic impact of preoperative serum tumor markers should be evaluated together with EGFR mutation status.
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影响因子：
5.3
作者：
Vassilakopoulos, T;Troupis, T;Gorgoulis, V
通讯作者：
Gorgoulis, V
影响因子：
20.4
作者：
Tanaka, Kosuke;Hata, Akito;Katakami, Nobuyuki
通讯作者：
Katakami, Nobuyuki
影响因子：
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作者：
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通讯作者：
Liu, Ting
影响因子：
158.5
作者：
Mok, Tony S.;Wu, Yi-Long;Fukuoka, Masahiro
通讯作者：
Fukuoka, Masahiro
影响因子：
--
作者：
Facchinetti, Francesco;Aldigeri, Raffaella;Tiseo, Marcello
通讯作者：
Tiseo, Marcello