Clinical value of CEA, CA125, and CYFRA21-1 levels in efficacy evaluation of EGFR-TKIs in the treatment of EGFR mutation-positive non-small cell lung adenocarcinoma

doi:10.3969/j.issn.1004-583X.2021.03.006

Abstract

Abstract:

Objective To explore the relationship of treatment effects between the correlation of carcinoembryonic antigen(CEA), carbohydrate antigen 125(CA125), cytokeratin 19 fragment antigen 21-1(CYFRA21-1) level and clinical effect of epidermal growth factor receptor-tyrosine kinase inhibitors(EGFR-TKIs) for lung adenocarcinoma patients with epidermal growth factor receptor (EGFR) mutation. Methods One hundred and eighty six patients with EGFR mutations of advanced non-small cell lung cancer(NSCLC) from our hospital were selected. The first generation of EGFR-TKIs was used for therapy, and the correlation between CEA, CA125, CYFRA21-1 level before treatment and progression-free survival(PFS), overall survival(OS) was analyzed. Results The median PFS and OS of 186 lung adenocarcinoma patients receiving EGFR-TKIs treatment after treatment were 8.8 months and 22.9 months respectively, and the median PFS and OS of lung adenocarcinoma patients with high CEA level (13.2 months, 26.7 months) were better than those of patients with normal CEA level (8.1 months, 12.8 months), the median PFS and OS of patients with elevated CA125 level (13.5 months, 26.8 months) were better than those of patients with normal CA125 level (8.2 months, 12.4 months), the median PFS and OS of patients with normal CYFRA21-1 level (12.8 months, 25.8 months) were better than those of patients with elevated CYFRA21-1 level (8.3 months, 13.5 months)(P<0.05). Conclusion It is positive predictors for evaluating the efficacy of EGFR-TKIs, that the elevated levels of CEA and CA125 and normal levels of CYFRA21-1 in patients with EGFR-mutant lung adenocarcinoma.

Key words: carcinoma, non-small-cell lung, lung adenocarcinoma, epidermal-growth factor receptor tyrosine kinase inhibitors, carcinoembryonic antigen, CA-125 Antigen, prognosis

CLC Number:

R730.26

He Yiwen, Qiao Tiankui. Clinical value of CEA, CA125, and CYFRA21-1 levels in efficacy evaluation of EGFR-TKIs in the treatment of EGFR mutation-positive non-small cell lung adenocarcinoma[J]. Clinical Focus, 2021, 36(3): 220-224.

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URL: https://huicui.hebmu.edu.cn/EN/10.3969/j.issn.1004-583X.2021.03.006

https://huicui.hebmu.edu.cn/EN/Y2021/V36/I3/220

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References 20

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项目	例数	中位PFS(月)	Z值	P值	中位OS(月)	Z值	P值
年龄(岁)
≤70 >70	158 28	8.9 10.3	0.793	0.489	22.8 23.9	0.821	0.437
性别
男女	79 107	10.7 8.5	0.877	0.413	23.7 22.0	0.363	0.816
PS评分
0~1 2~4	157 29	9.8 4.9	4.249	<0.01	23.7 9.4	5.824	<0.01
临床分期
Ⅲb Ⅳ	11 175	9.2 8.6	0.611	0.523	23.5 22.7	0.482	0.724
EGFR基因
19外显子缺失突变	107	8.8			23.7
21外显子错义突变	72	7.9	0.923	0.384	19.4	1.034	0.202
其他	7	9.3			20.2
EGFR-TKIs治疗
埃克替尼	109	8.9			20.8
吉非替尼	51	9.6	0.284	0.941	22.5	0.862	0.433
厄洛替尼	26	10.8			23.1
远处转移
是否	65 121	6.9 11.0	4.146	<0.01	13.8 25.9	4.724	<0.01
CEA水平(ng/ml)
≤5 >5	64 122	8.1 13.2	4.071	<0.01	12.8 26.7	5.643	<0.01
CA125水平(U/ml)
≤35 >35	57 129	8.2 13.5	3.954	<0.01	12.4 26.8	5.923	<0.01
CYFRA21-1(ng/ml)
≤3.3 >3.3	105 81	12.8 8.3	4.672	<0.01	25.8 13.5	5.028	<0.01

项目	例数	中位PFS(月)	Z值	P值	中位OS(月)	Z值	P值
年龄(岁)
≤70 >70	158 28	8.9 10.3	0.793	0.489	22.8 23.9	0.821	0.437
性别
男女	79 107	10.7 8.5	0.877	0.413	23.7 22.0	0.363	0.816
PS评分
0~1 2~4	157 29	9.8 4.9	4.249	<0.01	23.7 9.4	5.824	<0.01
临床分期
Ⅲb Ⅳ	11 175	9.2 8.6	0.611	0.523	23.5 22.7	0.482	0.724
EGFR基因
19外显子缺失突变	107	8.8			23.7
21外显子错义突变	72	7.9	0.923	0.384	19.4	1.034	0.202
其他	7	9.3			20.2
EGFR-TKIs治疗
埃克替尼	109	8.9			20.8
吉非替尼	51	9.6	0.284	0.941	22.5	0.862	0.433
厄洛替尼	26	10.8			23.1
远处转移
是否	65 121	6.9 11.0	4.146	<0.01	13.8 25.9	4.724	<0.01
CEA水平(ng/ml)
≤5 >5	64 122	8.1 13.2	4.071	<0.01	12.8 26.7	5.643	<0.01
CA125水平(U/ml)
≤35 >35	57 129	8.2 13.5	3.954	<0.01	12.4 26.8	5.923	<0.01
CYFRA21-1(ng/ml)
≤3.3 >3.3	105 81	12.8 8.3	4.672	<0.01	25.8 13.5	5.028	<0.01

变量	赋值	变量	赋值
年龄	≤70岁=0;>70=1	EGFR-TKIs治疗	埃克替尼=1;吉非替尼=2;厄洛替尼=3
性别	男=0;女=1	是否远处转移	否=0;是=1;
PS评分	0~1分=0;2~4分=1	CEA水平	≤5 ng/ml=0;>5 ng/ml=1
临床分期	Ⅲb=0;Ⅳ=1	CA125水平	≤35 U/ml=0;>35 U/ml=1
EGFR基因	19外显子缺失突变=1;21外显子错义突变=2;其他=3	CYFRA21-1水平	≤3.3 ng/ml=0;>3.3 ng/ml=1

变量	赋值	变量	赋值
年龄	≤70岁=0;>70=1	EGFR-TKIs治疗	埃克替尼=1;吉非替尼=2;厄洛替尼=3
性别	男=0;女=1	是否远处转移	否=0;是=1;
PS评分	0~1分=0;2~4分=1	CEA水平	≤5 ng/ml=0;>5 ng/ml=1
临床分期	Ⅲb=0;Ⅳ=1	CA125水平	≤35 U/ml=0;>35 U/ml=1
EGFR基因	19外显子缺失突变=1;21外显子错义突变=2;其他=3	CYFRA21-1水平	≤3.3 ng/ml=0;>3.3 ng/ml=1

变量	回归系数	标准误	Wald χ²值	P值	OR值	95%CI
变量	回归系数	标准误	Wald χ²值	P值	OR值	下限	上限
PS评分(2~4分)	1.956	0.523	17.853	<0.01	5.753	2.538	9.838
CEA水平	-1.256	0.424	9.824	<0.01	3.964	1.163	5.637
CA125水平	-1.442	0.432	12.532	<0.01	4.234	1.545	5.853
CYFRA21-1水平	1.895	0.495	14.828	<0.01	4.533	1.824	7.725