中华医学杂志
中華醫學雜誌
중화의학잡지
National Medical Journal of China
2014年
30期
2327-2331
,共5页
金波%张岩巍%张雪艳%李榕%楼煜清%牛艳洁%黄艾弥%韩宝惠
金波%張巖巍%張雪豔%李榕%樓煜清%牛豔潔%黃艾瀰%韓寶惠
금파%장암외%장설염%리용%루욱청%우염길%황애미%한보혜
癌,非小细胞肺%癌胚抗原%基因,erbB-1%突变%表皮生长因子受体-酪氨酸激酶抑制剂
癌,非小細胞肺%癌胚抗原%基因,erbB-1%突變%錶皮生長因子受體-酪氨痠激酶抑製劑
암,비소세포폐%암배항원%기인,erbB-1%돌변%표피생장인자수체-락안산격매억제제
Carcinoma,non-small-cell lung%Carcinoembryonic antigen%Genes,erbB-1%Mutation%Epidermal growth factor receptor-tyrosine kinase inhibitors
目的 探讨外周血癌胚抗原(CEA)水平与晚期非小细胞肺癌(NSCLC)患者表皮生长因子受体-酪氨酸激酶抑制剂(EGFR-TKI)疗效的相关性.方法 回顾性分析2010年9月至2013年12月上海交通大学附属胸科医院呼吸内科接受EGFR-TKI治疗的EGFR突变阳性的170例晚期NSCLC患者的临床资料.分析治疗前不同基线外周血CEA水平与EGFR-TKI疗效的相关性.本研究中CEA水平正常值为＜5μg/L.结果 患者总体客观缓解率为37.6％,疾病控制率为90.0％.CEA升高者接受EGFR-TKI治疗具有更好地疾病控制率(94.3％比80.4％,P=0.022).影响无疾病进展时间(PFS)的单因素分析显示在一定范围内随着基线CEA水平的升高,风险比(HR)值逐渐增大;CEA＞ 20 μg/L者与CEA≤20 μg/L者PFS差异有统计学意义(HR=1.444,95％ CI:1.036 ～2.014,P=0.030).细胞角蛋白19片段(CYFRA21-1)水平升高者较正常者PFS差异无统计学意义(HR=1.167,95％ CI:0.840～1.622,P=0.357).EGFR-TKI治疗后1个月内CEA水平的变化类型与疗效有显著相关性(HR =7.344,95％ CI:2.903～ 18.578,P＜0.001).结论 外周血CEA水平与晚期NSCLC患者EGFR-TKI疗效密切相关,基线CEA高者更能在EGFR-TKI治疗中获益.
目的 探討外週血癌胚抗原(CEA)水平與晚期非小細胞肺癌(NSCLC)患者錶皮生長因子受體-酪氨痠激酶抑製劑(EGFR-TKI)療效的相關性.方法 迴顧性分析2010年9月至2013年12月上海交通大學附屬胸科醫院呼吸內科接受EGFR-TKI治療的EGFR突變暘性的170例晚期NSCLC患者的臨床資料.分析治療前不同基線外週血CEA水平與EGFR-TKI療效的相關性.本研究中CEA水平正常值為＜5μg/L.結果 患者總體客觀緩解率為37.6％,疾病控製率為90.0％.CEA升高者接受EGFR-TKI治療具有更好地疾病控製率(94.3％比80.4％,P=0.022).影響無疾病進展時間(PFS)的單因素分析顯示在一定範圍內隨著基線CEA水平的升高,風險比(HR)值逐漸增大;CEA＞ 20 μg/L者與CEA≤20 μg/L者PFS差異有統計學意義(HR=1.444,95％ CI:1.036 ～2.014,P=0.030).細胞角蛋白19片段(CYFRA21-1)水平升高者較正常者PFS差異無統計學意義(HR=1.167,95％ CI:0.840～1.622,P=0.357).EGFR-TKI治療後1箇月內CEA水平的變化類型與療效有顯著相關性(HR =7.344,95％ CI:2.903～ 18.578,P＜0.001).結論 外週血CEA水平與晚期NSCLC患者EGFR-TKI療效密切相關,基線CEA高者更能在EGFR-TKI治療中穫益.
목적 탐토외주혈암배항원(CEA)수평여만기비소세포폐암(NSCLC)환자표피생장인자수체-락안산격매억제제(EGFR-TKI)료효적상관성.방법 회고성분석2010년9월지2013년12월상해교통대학부속흉과의원호흡내과접수EGFR-TKI치료적EGFR돌변양성적170례만기NSCLC환자적림상자료.분석치료전불동기선외주혈CEA수평여EGFR-TKI료효적상관성.본연구중CEA수평정상치위＜5μg/L.결과 환자총체객관완해솔위37.6％,질병공제솔위90.0％.CEA승고자접수EGFR-TKI치료구유경호지질병공제솔(94.3％비80.4％,P=0.022).영향무질병진전시간(PFS)적단인소분석현시재일정범위내수착기선CEA수평적승고,풍험비(HR)치축점증대;CEA＞ 20 μg/L자여CEA≤20 μg/L자PFS차이유통계학의의(HR=1.444,95％ CI:1.036 ～2.014,P=0.030).세포각단백19편단(CYFRA21-1)수평승고자교정상자PFS차이무통계학의의(HR=1.167,95％ CI:0.840～1.622,P=0.357).EGFR-TKI치료후1개월내CEA수평적변화류형여료효유현저상관성(HR =7.344,95％ CI:2.903～ 18.578,P＜0.001).결론 외주혈CEA수평여만기NSCLC환자EGFR-TKI료효밀절상관,기선CEA고자경능재EGFR-TKI치료중획익.
Objective To explore the relevance of carcinoembryonic antigen (CEA) level and efficacy of epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI) in advanced non-small cell lung cancer (NSCLC) harboring EGFR mutations.Methods Between September 2010 and December 2013,170 NSCLC patients harboring EGFR mutations receiving EGFR-TKI treatment at pulmonary medicine department of Shanghai Chest hospital were retrospectively screened.They were screened for clinical characteristics,efficacy of EGFR-TKI,and tumor markers (CEA/cytokerantin-19-fragment CYFRA21-1) at an initial diagnosis.The cutoff value for CEA was 5 μg/L.Results The overall objective response rate (ORR) was 37.6％ and disease control rate (DCR) 90.0％.Those with high CEA levels (＞5 μg/L) had better DCR (94.3％ vs 80.4％,P =0.022).Univariate analysis showed that patients with high CEA levels (≥20 μg/L) had significantly longer progression-free survival (PFS) than those with low CEA level (HR =1.444,95％ CI:1.036-2.014,P =0.030).HR value increased with rising CEA levels.No significant difference in PFS existed between high-CYFRA21-1 and normal-CYFRA21-1 groups (HR =1.167,95％ CI:0.840-1.622,P =0.357).Close follow-ups were conducted for 51 patients on EGFR-TKI treatment.And their CEA levels was tested within one month after treatment.The patients in descending type group had longer PFS than other two types (HR=7.344,95％CI:2.903-18.578,P＜0.001).Conclusions CEA level has a close correlation with the efficacy of EGFR-TKI treatment.And a high CEA level may be a predictive marker for better response and longer PFS in advanced NSCLC.
