血清CEA水平与晚期肺癌治疗方法以及脑转移的关系.doc

晚期肺腺癌：不同CEA浓度梯度，不同TKI敏感性及预后 郭勇1 刘杰1 贾永旭1 李醒亚2 2 通讯作者：李醒亚，E-mail： HYPERLINK mailto:doctorgyong@ doctorgyong@ 1郑州大学第一附属医院肿瘤科 郑州450052；2河南省肿瘤医院肿瘤内科 郑州 450008 ［摘要］目的：本研究旨在探讨晚期肺腺癌患者不同血清癌胚抗原（carcinoembryonic antigen, CEA）浓度梯度与表皮生长因子受体酪氨酸激酶抑制剂（epidermal growth factor receptor tyrosine kinase inhibitors，EGFR-TKI）疗效以及预后之间的关系。方法：78例晚期肺腺癌患者，分别以5ng/ml、200ng/ml为分界点进行分组，分析三组患者口服EGFR-TKI（厄罗替尼或吉非替尼）的疗效和和生存资料。结果：血清CEA≤5ng/mL组患者的疾病控制率 (CR+PR+SD)为45.1%，无疾病进展时间（PFS）为5.6月，中位生存时间（OS）为8.9月；5ng/mL ＜CEA ≤200ng/ml组患者的疾病控制率为81.6%，无疾病进展时间为9.7月，中位生存时间为12.9月；CEA ＞200ng/ml组患者的疾病控制率为44.4%，无疾病进展时间为4. 8月，中位生存时间为8.4月。三组病人的疾病控制率、PFS、OS差异显著，具有统计学意义。结论：晚期肺腺癌患者，服用EGFR-TKI前不同血清CEA浓度梯度，提示不同的EGFR-TKI疗效和预后。当5ng/mL ＜CEA ≤200ng/ml时提示较好的疗效和预后，当血清CEA≤5ng/mL和CEA ＞200ng/ml时提示较差的疗效和预后。 ［关键词］ 癌胚抗原；表皮生长因子受体酪氨酸激酶抑制剂；晚期肺腺癌 中图分类号：R734.2 文献标识码：A Correlation between serum CEA level, EGFR-TKI sensitivity and prognosis in advanced lung cancer GUO Yong，LIU Jie，JIA Yong-xu，LI Xing-ya（Department of Medical Oncology，The First Affiliated Hospital of Zehngzhou University，Zhengzhou Henan 450052，China） Correspondence to：LI Xing-ya E-mail：doctorgyong@ ［Abstract］ Objective: The aim of this study is to explore the association between the serum levels of CEA and the sensitivity of TKI and prognosis in advanced lung cancer. Method: Seventy-eight cases of advanced lung cancer patients were included in this study. The serum CEA level was classified into three groups according to two nodes of concentration: normal serum CEA level (or =5.0 ng/ml) (N),moderated elevated serum CEA level (5ng/mL ＜CEA ≤200ng/ml) (M) and severe elevated serum CEA level (200.0 ng/ml) (S). Analyze the efficacy of EGFR-TKI (erlotinib or gefitinib) and survival data among these three groups of patients. Relationship between different serum level of CEA and the efficacy of TKI and survival were analyzed among three groups. Results: Disease control rate (DCR) in patients with normal serum CEA level was 45.1%, 81.6%in patients with moderated ele