血清肿瘤标志物与非小细胞肺癌中表皮生长因子受体基因突变的相关性研究

计海芬; 罗锐; 陈彧

doi:10.13898/j.cnki.issn.1000-2200.2022.06.026

血清肿瘤标志物与非小细胞肺癌中表皮生长因子受体基因突变的相关性研究

Relationship between serum tumor markers and EGFR gene mutation in NSCLC based on logistic regression and ROC curve analysis

摘要

摘要:
目的采用logistic回归和受试者特征曲线(ROC)方法评价血清肿瘤标志物与非小细胞肺癌(NSCLC)中表皮生长因子受体(EGFR)基因突变的相关性。
方法收集肺腺癌住院病人128例，记录病人是否存在吸烟史，并收集病人初诊时静脉血5 mL，分离血清3 mL，检测病人血清肿瘤标志物。按照EGFR基因检测结果分为EGFR基因突变组和EGFR基因非突变组，比较2组病人的一般临床特征，基于logistic回归模型，绘制ROC曲线，计算曲线下面积(AUC)评价各指标及联合诊断的价值。
结果EGFR的突变与病人的性别、吸烟史、血清鳞状细胞癌抗原(SCC)以及血清糖类抗原(CA125)水平相关(P < 0.05~P < 0.01)，NSCLC病人中女性发生突变频率高于男性(P < 0.01)，有吸烟史病人EGFR的突变频率低于无吸烟史病人(P < 0.01)，血清SCC水平阴性病人EGFR的突变频率高于血清SCC水平阳性(P < 0.01)，血清CA125阴性EGFR的突变频率高于CA125阳性病人(P < 0.05)。在血清肿瘤标志物中对EGFR基因突变诊断价值具有统计学意义的是性别、CA125、SCC以及病人的吸烟史(P < 0.05)，指标联合诊断中，性别+SCC、性别+ CA125+SCC、性别+SCC+吸烟史、CA125+SCC+吸烟史、性别+CA125+SCC+吸烟史五者的AUC均>0.75(P < 0.05)，具有较高的诊断价值。
结论血清肿瘤标志物中SCC和CA125与NSCLC中发生EGFR突变存在着较好的相关性，与其他临床资料(性别、吸烟史)相结合增强了EGFR的预测鉴别能力，值得临床进一步推广应用。

Abstract:
ObjectiveTo evaluate the correlation between serum tumor markers and epidermal growth factor receptor(EGFR) gene mutation in non-small cell lung(NSCLC) cancer by logistic regression and receiver operating characteristic(ROC) curve.
MethodsA total of 128 hospitalized patients with lung adenocarcinoma were collected and 5 mL of venous blood was collected at the initial diagnosis, 3 mL serum was separated, and serum tumor markers were detected. According to the results of EGFR gene detection, they were divided into EGFR gene mutation group and EGFR gene non-mutation group. The general clinical characteristics of two groups of patients with NSCLC were compared. The ROC curve was drawn based on logistic regression model, and the area under the curve(AUC) was calculated to evaluate the value of each index and the combined diagnosis.
ResultsEGFR mutation was associated with gender, smoking history, SCC and CA125(P < 0.05 to P < 0.01). The mutation frequency of EGFR in female patients with NSCLC was higher than that in male(P < 0.01). The mutation frequency of EGFR in patients with smoking history was lower than that in patients without smoking history(P < 0.01). The mutation frequency of EGFR in patients with negative serum SCC was higher than that in patients with positive serum SCC(P < 0.01). The mutation frequency of EGFR in patients with negative serum CA125 was higher than that in patients with positive CA125(P < 0.05). Among the serum tumor markers, gender, CA125, SCC and smoking history had higher diagnostic value with EGFR gene mutation(P < 0.05). At the same time, the combined diagnosis of these indicators, such as gender+SCC, gender+CA125+SCC, gender+SCC+smoking history, CA125+SCC+smoking history, gender+CA125+SCC+smoking history, which all had AUC value more than 0.75(P < 0.05), had high diagnostic value.
ConclusionsThere is a good correlation between SCC and CA125 in serum tumor markers and EGFR mutation in NSCLC.The combination of SCC and CA125 with other clinical data(gender, smoking history) can enhance the predictive discrimination of EGFR, which is worthy of further clinical application.

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