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目的探讨PET-CT的标准摄取值(SUV)、血清癌胚抗原(CEA)、细胞角蛋白19的可溶性片段(CYFRA21-1)对靶向药物治疗非小细胞肺癌疗效的预测作用。方法对39例非小细胞肺癌患者在治疗前,进行EGFR基因突变、PET-CT SUV值、血清CEA、CYFRA21-1检测,治疗2周观察血清CEA、CYFRA21-1下降程度,计算以上各项指标与患者无进展生存期(PFS)及总生存期(OS)的关系。结果 SUV值≤5的患者及治疗2周后CEA水平下降≥50%的患者获得更佳的PFS及OS。但CYFRA21-1水平下降≥50%的患者,并未获得更长的PFS及OS。EGFR突变的患者SUV均值较EGFR野生型患者明显低(P<0.05)。治疗后EGFR基因突变的患者较野生型患者更可能获得CEA下降≥50%(P<0.05)。二元logistic回归分析结果表明,SUV值≤5为EGFR基因突变的独立预测因素(P<0.001)。结论 PET-CT的SUV值、用药前期CEA水平的变化,可以预测靶向药物治疗非小细胞肺癌的疗效。
Objective To investigate the predictive value of PET-CT standard injections (SUV), serum carcinoembryonic antigen (CEA), cytokeratin 19 soluble fraction (CYFRA21-1) on the efficacy of targeted drug therapy for non-small cell lung cancer. Methods 39 patients with non-small cell lung cancer before treatment, EGFR gene mutation, PET-CT SUV value, serum CEA, CYFRA21-1 detection, the treatment of 2 weeks to observe the serum CEA, CYFRA21-1 decline in the calculation of the above indicators And patient progression-free survival (PFS) and overall survival (OS). Results Patients with SUV values ≤5 and those with CEA levels ≥50% 2 weeks after treatment achieved better PFS and OS. However, patients with a ≥50% reduction in CYFRA21-1 levels did not achieve longer PFS and OS. The mean SUV of patients with EGFR mutation was significantly lower than that of EGFR wild type (P <0.05). Patients with EGFR mutations after treatment were more likely to have CEA reductions ≥50% (P <0.05) as compared with wild-type patients. Binary logistic regression analysis showed that SUV value ≤5 was an independent predictor of EGFR gene mutation (P <0.001). Conclusions The SUV value of PET-CT and the change of CEA level in pre-treatment can predict the efficacy of targeted drug therapy for non-small cell lung cancer.