Correlation Between Serum CYFRA21-1,CEA And EGFR Gene Mutation In Lung Cancer

Objective: To explore the relationship between serum CYFRA21-1 and CEA levels and EGFR gene mutations in patients with non-small cell lung cancer before initial anticancer treatment,and to explore the influencing factors of EGFR gene mutation.Methods: 1.Retrospectively collected 220 patients with non-small cell lung cancer who underwent EGFR gene mutation detection in the Department of Pathology,First Affiliated Hospital of Wannan Medical College from January 2015 to December 2017,and recorded the relevant medical records of patients,including age and gender.,pathological typing,specimen source,EGFR gene mutation and serum CYFRA21-1 and serum CEA levels 1 week before the initial anti-tumor treatment.2.EGFR gene detection using mutation amplification block system(ARMS),serum CYFRA21-1,CEA detection using chemiluminescence immunoassay.Results: EGFR gene mutations occurred in 117 of the 220 patients enrolled,with a mutation rate of 53.18%.Exon mutations 18-21 were predominant,with deletion mutations in exon 19(47.86%)and point mutations in exon 21(43.59%).A total of 90 females had mutations in 68 cases,the mutation rate was 75.56%;130 males,49 mutations,the mutation rate was 37.69%.The difference was statistically significant(P < 0.001).There were 192 cases of adenocarcinoma,113 cases of mutation,mutation rate 58.85%;28 cases of non-adenocarcinoma,4 cases of mutation,mutation rate 14.29%.The difference was statistically significant(P < 0.001).EGFR mutations are associated with gender and lung cancer pathology.There were 112 cases of age <65 years old,59 cases of mutation,53 cases of wild,mutation rate 52.68%;108 cases of age?65 years old,58 cases of mutation,50 cases of wild,the mutation rate was 53.70%.There was no significant difference between the two(P>0.05).There were 20 cases of surgical specimens,13 cases of mutations,7 cases of wild,178 cases of biopsy specimens,90 cases of mutations,88 cases of wild,22 cases of pleural fluid exfoliated cells,18 cases of mutation,4 cases of wild,the difference was not statistically significant(P >0.05).There was no correlation between patient age,specimen source and EGFR gene mutations.Serum CYFRA21-1 levels were normal in 25 cases,15 cases were mutated,wild type was 10 cases,the mutation rate was 60%;serum CYFRA21-1 level was highly expressed in 195 cases,102 cases were mutations,93 cases were wild,and the mutation rate was 52.31%.Serum CYFRA21-1 levels were not significantly different between the EGFR gene mutation group and the wild group(P=0.468),and were not associated with EGFR gene mutations.Serum CEA levels were normal in 53 cases,17 cases were mutated,36 cases were wild type,the mutation rate was 32.08%;serum CEA level was high in 167 cases,100 cases were mutated,and wild type was 67 cases,the mutation rate was 59.88%.The difference between the two was statistically significant(P < 0.001).The mutation of EGFR gene has a certain relationship with serum CEA concentration.In the subgroup analysis,CEA < 5.00 ng / ml mutation rate 32.08%;5 ng / ml ? CEA ? 20 ng / ml mutation rate 50%;CEA > 20 ng / ml mutation rate 63.41%.High serum CEA concentrations suggest a high likelihood of EGFR mutations.In the study between serum CYFRA21-1,CEA expression levels and 19 and 21 exon mutations,serum CYFRA21-1 expression levels were found to be no difference between EGFR19 and 21 point mutations(P>0.05),while serum CEA expression levels differed between exon 19 mutation and exon 21 mutation(P=0.049).Among the 56 cases of exon 19 mutation,CEA was highly expressed in 44 cases(78.57%);in 51 cases of exon 21 mutation,CEA was highly expressed in 47 cases(92.16%),suggesting that high serum CEA expression levels are more likely for EGFR-driven genes to undergo exon 21 mutations.Conclusion: 1.The expression level of serum CYFRA21-1 was not related to the driving state of EGFR gene.2.Women?adenocarcinoma subtypes and serum CEA expression levels are related to EGFR gene driving status and are independent predictors of EGFR mutations in patients with non-small cell lung cancer.3.High serum expression level of CEA suggests that the EGFR gene is more likely to undergo exon 21 mutation.