CAJ | 학술논문

目的：观察非小细胞肺癌（NSCLC）患者经吉非替尼治疗后血清癌胚抗原（CEA）水平的变化，并探讨其临床意义。方法共纳入40例NSCLC患者，临床分期Ⅲ～Ⅳ期，给予吉非替尼联合基础放疗进行治疗，若发现肿瘤进展或不能耐受的毒性反应则停止，治疗后，患者按照RECIST 1．1（2009年颁布的实体瘤疗效评价标准）标准被分为控制组和非控制组，采集患者清晨外周血，利用电化学发光免疫法测定血清CEA。将治疗前患者分为高CEA组（ CEA＞30μg／L）和低CEA组（ CEA≤30μg／L），两组一直随访到2014年6月，记录随访过程中的不良反应及无疾病进展生存率（PFS）。结果治疗前控制组和非控制组之间CEA水平无统计学差异（P＞0．05），治疗后两组均下降，以控制组为著（ P均＜0．01）；高CEA组和低CEA组之间不良反应无统计学差异（ P＞0．05）；高CEA组9、12个月的无疾病进展生存期较低CEA组长（P＜0．01）。结论吉非替尼治疗后，NSCLC患者血清CEA水平下降；血清CEA水平可作为预测吉非替尼治疗NSCLC的疗效及患者预后的生物学标记。
목적：관찰비소세포폐암（NSCLC）환자경길비체니치료후혈청암배항원（CEA）수평적변화，병탐토기림상의의。방법공납입40례NSCLC환자，림상분기Ⅲ～Ⅳ기，급여길비체니연합기출방료진행치료，약발현종류진전혹불능내수적독성반응칙정지，치료후，환자안조RECIST 1．1（2009년반포적실체류료효평개표준）표준피분위공제조화비공제조，채집환자청신외주혈，이용전화학발광면역법측정혈청CEA。장치료전환자분위고CEA조（ CEA＞30μg／L）화저CEA조（ CEA≤30μg／L），량조일직수방도2014년6월，기록수방과정중적불량반응급무질병진전생존솔（PFS）。결과치료전공제조화비공제조지간CEA수평무통계학차이（P＞0．05），치료후량조균하강，이공제조위저（ P균＜0．01）；고CEA조화저CEA조지간불량반응무통계학차이（ P＞0．05）；고CEA조9、12개월적무질병진전생존기교저CEA조장（P＜0．01）。결론길비체니치료후，NSCLC환자혈청CEA수평하강；혈청CEA수평가작위예측길비체니치료NSCLC적료효급환자예후적생물학표기。
Objective To observe the changes in levels of serum carcinoembryonic antigen ( CEA) in patients before and after gefitinib treatment of non-small-cell lung cancer ( NSCLC) and to investigate the clinical significance .Methods Forty patients with NSCLC in clinical stage of Ⅲ~Ⅳwere treated with gefitinib and radiotherapy , and we stopped if the tumor progression or toxicity reaction were found in patients .After treatment , all patients were divided into the control group and non-control group according to RECIST1.1 (Response Evaluation Criteria in Solid Tumors in 2009).The periph-eral blood was collected in the morning to detect the serum CEA by electro-chemiluminescence immunoassay ( ECLIA ) . Before treatment , the patients were divided into the high CEA group ( CEA>30 μg/L) and low CEA group ( CEA ≤30μg/L) .Two groups were followed up to December , 2012 .The adverse reactions and progression free survival ( PFS) were recorded .Results There was no difference in CEA levels before treatment between the control group and non -control group(P>0.05),but the levels of CEA in the control group decreased more after treatment than that of the non -control group (all P<0.01).No difference was found in the adverse reaction between the high CEA group and the low CEA group (P>0.05), but the PFS at 9 months and 12 months was higher in the high CEA group than that in the low CEA group (P<0.01).Conclusion The serum CEA level is decreased in NSCLC patients after treatment of gefitinib , which can be-come the biological marker in predicting the efficacy and prognosis .