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Published online: 2024-04-08

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EGFR gene mutation and association with carcinoembryonic antigen status in non-small cell lung cancer — a cross-sectional study

Lam Van Ngo1, Toan Khanh Nguyen1, Hung Duc Tran2, Uyen Tu Thi Nguyen1, Hien Thu Thi Tran1, Thanh Van Le1

Abstract

Introduction. Epidermal growth factor receptor (EGFR) gene mutations are an important aspect in the diagnosis and treatment of non-small cell lung cancer (NSCLC). Some studies suggest that serum CEA levels may serve as a predictor of the outcome of EGFR mutations. Therefore, we conducted a study to determine the prevalence of EGFR gene mutations and evaluate the prognostic value of serum CEA levels in predicting the frequency of EGFR gene mutations in NSCLC. 

Material and methods. From January 2018 to December 2022, a cross-sectional study was conducted on 384 NSCLC patients at the Nghe An Oncology Hospital, in Vietnam. EGFR mutations were analyzed using the real-time PCR method to determine the sensitivity and specificity of CEA values in predicting EGFR mutation traits by ROC curve analysis, and the association was assessed using univariate and multivariate logistic regression analyses. 

Results. The EGFR gene mutation rate in NSCLC is 41.9%. Among patients with genetic mutations, 50.9% had the del exon 19mutation, 34.8% had the L858R exon 21 mutation, 3.7% had rare exon 18 mutations, 5.6% had dual mutations, and 5.0% had exon 20 insertion mutations. The CEA cutoff value was determined to be 8.95. The sensitivity and specificity of CEA were 76.4% and 47.5%, respectively, and the area under the curve (AUC) was 0.627 (95% CI 0.571–0.683; p < 0.01). The EGFR gene mutation was found to be closely associated with the CEA subgroup ≥ 8.95 ng/mL (OR 2.54; 95% CI 1.57–4.13). 

Conclusions. This study shows a high incidence of EGFR mutations in NSCLC and suggests that CEA can aid in predicting the likelihood of these mutations. 

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