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目的:探讨在表皮生长因子受体(EGFR)突变的晚期非小细胞肺癌患者中,血清癌胚抗原(CEA)对EGFR络氨酸激酶抑制剂(TKI)的疗效预测及预后影响。方法:回顾性分析了我院胸部肿瘤科接受EGFR-TKI治疗的EGFR突变患者,记录患者血清CEA水平,分析CEA水平与TKI疗效及患者预后的相关性。结果:83.1%患者基线CEA水平升高,56.6%患者在TKI治疗后1月CEA下降幅度达到20%,取得了CEA response。72.3%的患者接受EGFR-TKI治疗后达到了影像学的客观缓解,CEA response与影像学缓解无相关性。全组患者接受TKI治疗的中位无疾病生存期为9.6个月,中位总生存期为22.0个月。多因素回顾分析显示,基线血清CEA水平及EGFR-TKI治疗时机是影响突变型NSCLC患者总生存的独立影响因素。结论:血清CEA水平不能预测晚期EGFR突变患者的TKI疗效,但基线CEA升高患者预后更佳。
Objective: To investigate the effect of serum carcinoembryonic antigen (CEA) on EGFR tyrosine kinase inhibitor (TKI) and prognosis in advanced non-small cell lung cancer patients with epidermal growth factor receptor (EGFR) mutation. Methods: We retrospectively analyzed EGFR-TKI-treated patients with EGFR mutations in our department of thoracic oncology. The serum CEA level was recorded. The correlation between CEA level and TKI efficacy and prognosis was analyzed. Results: Baseline CEA levels increased in 83.1% of patients and CEA reduction was achieved in 56.6% of patients after January 1 of TKI treatment. CEA response was achieved. 72.3% of patients received objective EGFR-TKI imaging relief, CEA response and imaging relevancy. The median duration of disease-free survival for all patients receiving TKI was 9.6 months, with a median overall survival of 22.0 months. Multivariate analysis showed that baseline serum CEA level and EGFR-TKI treatment timing were independent influencing factors for overall survival in patients with mutant NSCLC. CONCLUSIONS: Serum CEA levels can not predict the efficacy of TKI in patients with advanced EGFR mutations, but patients with elevated baseline CEA have a better prognosis.