Division of Thoracic Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC.
Institute of Biotechnology, National Tsing Hua University, Hsinchu, Taiwan, ROC.
Sci Rep. 2020 Feb 7;10(1):2066. doi: 10.1038/s41598-020-59031-1.
Changes in expression patterns of serum carcinoembryonic antigen at initial diagnosis (CEA) and disease progression (CEA) in lung cancer patients under EGFR-tyrosine kinase inhibitors (TKI) treatment may reflect different tumor progression profiles. Of the 1736 lung cancer patients identified from the cancer registry group between 2011 to 2016, we selected 517 patients with advanced stage adenocarcinoma, data on EGFR mutation status and CEA, among whom were 288 patients with data on CEA, eligible for inclusion in the correlation analysis of clinical characteristics and survival. Multivariable analysis revealed that CEA expression was associated with poor progression-free survival in patients harboring mutant EGFR. Moreover, CEA and CEA were associated with the good and poor post-progression survival, respectively, in the EGFR-mutant group. Cell line experiments revealed that CEA expression and cancer dissemination can be affected by EGFR-TKI selection. EGFR-mutant patients, exhibiting high CEA (≥5 ng/mL) and low CEA (<5 ng/mL), showed a potential toward displaying new metastasis. Taken together, these findings support the conclusion that EGFR mutation status is a critical factor in determining prognostic potential of CEA and CEA in patients under EGFR-TKI treatment, and CEA and CEA are associated with distinct cancer progression profiles.
在 EGFR-酪氨酸激酶抑制剂 (TKI) 治疗下，肺癌患者初始诊断时（CEA）和疾病进展时（CEA）的表达模式变化可能反映出不同的肿瘤进展特征。在 2011 年至 2016 年间从癌症登记组中确定的 1736 名肺癌患者中，我们选择了 517 名晚期腺癌患者，这些患者具有 EGFR 突变状态和 CEA 数据，其中 288 名患者具有 CEA 数据，符合纳入临床特征和生存相关性分析的条件。多变量分析显示，CEA 表达与携带突变型 EGFR 的患者无进展生存期不良相关。此外，CEA 和 CEA 分别与 EGFR 突变组的良好和不良进展后生存相关。细胞系实验表明，CEA 表达和癌症转移可受 EGFR-TKI 选择的影响。表现出高 CEA（≥5ng/mL）和低 CEA（<5ng/mL）的 EGFR 突变型患者有出现新转移的潜在可能。总之，这些发现支持以下结论：EGFR 突变状态是决定 EGFR-TKI 治疗患者中 CEA 和 CEA 预后潜力的关键因素，CEA 和 CEA 与不同的癌症进展特征相关。
