Department of Respiratory and Critical Care Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
Department of Cardiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
Tumori. 2021 Jun;107(3):216-225. doi: 10.1177/0300891620947159. Epub 2020 Aug 6.
To retrospectively explore the survival predictors and treatment efficacy of advanced pneumonic-type lung adenocarcinoma (P-ADC).
Retrospective analysis of clinical data and survival follow-up was undertaken on 41 patients with advanced P-ADC from January 1, 2009, to April 30, 2019. Analysis on tumor biomarkers such as carcinoembryonic antigen (CEA), neuron-specific enolase (NSE), and the cytokeratin-19-fragment (Cyfra21-1) were undertaken. The patients in this study were divided into three groups based on usage of tyrosine kinase inhibitor (TKI): TKI therapy group (including combination with chemotherapy), non-TKI therapy group (chemotherapy alone), and palliative care group.
More than half of the patients had higher levels of tumor biomarkers and the incidence of NSE was highest (81.8%), followed by CEA (74.4%) and Cyfra21-1 (74.1%). All patients had abnormal findings on chest computed tomography and with adenocarcinoma pathology. The overall survival (OS) time was 10.4 months in TKI group, 8.8 months in the non-TKI group, and 2.1 months in the palliative care group. Patients with higher level of serum Cyfra21-1 had insignificantly shorter survival time compared to those with normal Cyfra21-1 ( = 0.067). TKI therapy and non-TKI therapy provided a better prognosis prediction compared to palliative care. TKI therapy improved prognosis compared to non-TKI therapy. The comprehensive based TKI therapy provided improved OS vs the non-TKI therapy.
TKI-based therapy could improve the prognosis and OS for advanced P-ADC. This study recommends the analysis of mutations for all patients with advanced P-ADC.
回顾性探讨晚期肺炎型肺腺癌（P-ADC）的生存预测因素和治疗效果。
回顾性分析 2009 年 1 月 1 日至 2019 年 4 月 30 日期间 41 例晚期 P-ADC 患者的临床资料和生存随访。对癌胚抗原（CEA）、神经元特异性烯醇化酶（NSE）和细胞角蛋白 19 片段（Cyfra21-1）等肿瘤标志物进行分析。根据酪氨酸激酶抑制剂（TKI）的使用情况，将患者分为三组：TKI 治疗组（包括联合化疗）、非 TKI 治疗组（单独化疗）和姑息治疗组。
超过一半的患者肿瘤标志物水平较高，其中 NSE 发生率最高（81.8%），其次是 CEA（74.4%）和 Cyfra21-1（74.1%）。所有患者均有胸部 CT 异常表现和腺癌病理。TKI 组的总生存期（OS）为 10.4 个月，非 TKI 组为 8.8 个月，姑息治疗组为 2.1 个月。血清 Cyfra21-1 水平较高的患者与 Cyfra21-1 正常的患者相比，生存时间无显著差异（ = 0.067）。TKI 治疗和非 TKI 治疗的预后预测效果优于姑息治疗。TKI 治疗的预后优于非 TKI 治疗。综合 TKI 治疗较非 TKI 治疗的 OS 改善。
基于 TKI 的治疗可改善晚期 P-ADC 的预后和 OS。本研究建议对所有晚期 P-ADC 患者进行 突变分析。
