Serum CEA and CYFRA21-1 correlates with EGFR mutation and EGFR-TKI effectiveness in untreated NSCLC patients

Abstract

Objective To explore the predictive value of serum CEA and cytokeratin-19 fragments(CYFRA21-1)prior treatment for the epidermal growth factor receptor (EGFR) mutation and efficacy of tyrosine kinase inhibitors (TKI) in patients with non-small cell lung cancer. Methods The study was a clinical research.Totally 101 matched tissue and plasma samples were collected from Peking University People's Hospital from 2012 to 2013. All clinical specimens were analyzed for EGFR mutations in exons of 18, 19, 20 and 21 by ADx-ARMS and direct sequencing, and the serum levels of CEA and CYFRA21-1 were analyzed by ECLI. The correlation between EGFR mutant status and efficacy of EGFR-TKI and clinicopathological parameters were analyzed by χ2 test, Log-rank text and Cox proportional hazards regression model. Results The mutation rate was 60.4% (61/101) by ADx-ARMS and 33.7% (34/101) by direct sequencing. Mutations were more frequently observed in the higher serum CEA level patients(≥5 μg/L, 78.8%). However, the rates of EGFR mutations of different CEA levels were similar. Among the patients receiving TKI therapy, the efficacy of EGFR-TKI was closely related to serum CYFRA21-1 level prior treatment and EGFR mutation (χ2=8.903, P=0.003; χ2=28.590, P<0.001). And serum CYFRA21-1 level prior treatment and EGFR mutation were independent factors for EGFR-TKI treatment affecting PFS (RR=0.298, P<0.001; RR=0.086, P<0.001). Conclusion The mutation rate of EGFR was significantly related with the expression level of CEA prior treatment, and serum CEA and CYFRA21-1 levels prior treatment could be potential predictors of EGFR-TKI efficacy. (Chin J Lab Med, 2015, 38: 407-411) Key words: Carcinoma, non-small-cell lung; Carcinoembryonic antigen; Antigens, neoplasm; Keratin-19; Receptor, epidermal growth factor