魏崴，张洁霞，蓝玉宏，李勇生，钟标，黎佩建，白力(惠州市中心人民医院，广东惠州5600;广州医科大学第一附属医院)

吉非替尼治疗后非小细胞肺癌患者血清CEA水平变化及临床意义

魏崴1，张洁霞2，蓝玉宏1，李勇生1，钟标1，黎佩建1，白力1
(1惠州市中心人民医院，广东惠州516001;2广州医科大学第一附属医院)

摘要: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＞30 μg/L)和低CEA组(CEA≤30 μg/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。

关键词:肺肿瘤;吉非替尼;癌胚抗原

Changes in levels of serum CEA and its clinical significance in patients with non-small-cell lung cancer treated with gefitinib

WEI Wei1，ZHANG Jie-xia，LAN Yu-hong，LI Yong-sheng，ZHONG Biao，LI Pei-jian，BAI Li(1 Huizhoumunicipal Central Hospital，Huizhou 516001，China)

Abstract: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 ofⅢ～Ⅳwere treated with gefitinib and radiotherapy，and we stopped if the tumor progression or toxicity reaction were found in patients.After treatment，all patients weredivided into the control group and non-control group according to RECIST1.1(Response Evaluation Criteria in Solid Tumors in 2009).The peripheral blood was collected in themorning todetect the serum CEA by electro-chemiluminescence immunoassay(ECLIA).Before treatment，the patients weredivided into the high CEA group(CEA＞30 μg/L)and low CEA group(CEA≤30 μg/L).Two groups were followed up todecember，2012.The adverse reactions and progression free survival(PFS)were recorded.Results There was nodifference in CEA levels before treatment between the control group and non-control group(P＞0.05)，but the levels of CEA in the control groupdecreasedmore after treatment than that of the non-control group(all P＜0.01).Nodifference was found in the adverse reaction between the high CEA group and the low CEA group(P＞0.05)，but the PFS at 9months and 12months was higher in the high CEA group than that in the low CEA group(P ＜0.01).Conclusion The serum CEA level isdecreased in NSCLC patients after treatment of gefitinib，which can become the biologicalmarker in predicting the efficacy and prognosis.

Key words:carcinoma，non-small-cell lung; gefitinib;carcinoembryonic antigen

肺癌是目前世界上恶性程度最高的肿瘤，虽然化疗可以在一定程度上延长生存期，但对于中晚期非小细胞肺癌(NSCLC)患者疗效较差［1］。近年研究表明，NSCLC的分子靶向治疗是有效的，吉非替