The Predictive Value Of Serum CEA Levels For The EGFR Gene Mutation Status And The Efficacy Of Gefitinib Treatment Patients With Advanced NSCLC

Objective: To explore the predictive value of serum CEA levels for the EGFR gene statusand efficacy of first-line oral gefitinib treatment patients with advanced non-small celllung cancer (NSCLC).Methods:76cases of first-line oral gefitinib in patients withadvanced NSCLC clinical data were retrospectively analyzed.Real-time PCR method(ARMS assay) was applied to detect tumor tissues in patients with EGFR genemutations.the ECLI is used to measure patients’serum CEA level.Patients survival wereacquired by phone or outpatient follow-up.The relationship between patientsEGFR genemutation status and serum CEA level and its oral TKI treatment effect was analyzed.Results: Mutations of the EGFR gene of patients with advanced NSCLC were relatedwith gender, pathological type and serum CEA level. EGFR mutations were significantlymore prevalent in females,adenocarcinoma, and patients with serum CEA level≥5ng/ml（χ2value were4.413、4.956、6.105respectively,P were0.036、0.026、0.013respectively）.Further analysis showed that increased serum CEA level led to increasedEGFR mutation rate (χ2=11.0,P=0.004).The areas of CEA under the curve and95%CIwere0.723(0.609-0.838),area under the curve was significantly significant (P=0.001).Theshort term efficiency of gefitinib to patients with advanced NSCLC were closely related toserum CEA level,gender and EGFR mutations（P＜0.05）.Kaplan-Meier survival curveshowed that the serum CEA level has a significant correlation with the PFS,that is patientswith higher CEA levels correspond to longer PFS（P＝0.021）.Cox multivariate survivalanalysis indieated that EGFR mutation status and smoking history and serum CEAlevelwere independent factors with gefitinib pretreatment affecting PFS(P＜0.05).Conclusion:Serum CEA level is not only a useful predictor of the EGFR gene of patientswith advanced NSCLC,but also can be used as a predictor for the curative effectprediction of gefitinib treatment in patients with advanced NSCLC.