Abstract:
Objective To explore the correlation of serum tumor markers expression with the mutation rate and efficacy of the patients with EGFR-positive advanced lung adenocarcinoma.
Methods We selected 143 patients who were molecular pathologically diagnosed as positive EGFR mutation had received epidermal growth factor receptor tyrosine kinase inhibitors(EGFR-TKIs) treatment. According to CYFRA21-1, CEA and NSE expression levels before treatment, the patients were randomly divided into high level group and normal level group, respectively. We retrospectively analyzed progression-free survival(PFS) after the targeted therapy to explore the relationship between tumor markers expression before treatment and the efficacy of EGFR-TKIs as the first-line treatment on non-small cell lung cancer patients.
Results The efficacy of high CEA group was significantly better than that of normal CEA group(P < 0.05). The curative effect of normal CYFRA21-1 group was longer than that of high CYFRA21-1 group(P < 0.05). The median PFS had no significant difference between high NSE group and normal NSE group(P > 0.05). In subgroup analysis, ECOG PS < 2 group was better than PS≥2 group in PFS(P < 0.05). Non-smoking history group was better than smoking history group in curative effect(P < 0.05). Gender, age, TNM stage, mutation type and targeted drug had no significant differences in statistics. Multivariate survival analysis showed that median PFS was not related with ECOG PS score, smoking history or the state of CYFRA21-1, and the high expression of CEA was an independent prognostic factor for EGFR-TKIs as the first-line treatment.
Conclusion High CEA has a certain correlation with EGFR mutation status. It is a positive independent prognostic factor for the evaluation of targeted therapy.
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