<sup>18</sup>F‑FDG PET/CT SUV<sub>max</sub> and serum CEA levels as predictors for EGFR mutation state in Chinese patients with non‑small cell lung cancer

Gao,Xi-Can; Wei,Chun-Hua; Zhang,Rui-Guang; Cai,Qian; He,Yong; Tong,Fan; Dong,Ji-Hua; Wu,Gang; Dong,Xiao-Rong

doi:10.3892/ol.2020.11922

October-2020 Volume 20 Issue 4

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October-2020 Volume 20 Issue 4

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Article Open Access

¹⁸F‑FDG PET/CT SUV_max and serum CEA levels as predictors for EGFR mutation state in Chinese patients with non‑small cell lung cancer

Authors:
- Xi-Can Gao
- Chun-Hua Wei
- Rui-Guang Zhang
- Qian Cai
- Yong He
- Fan Tong
- Ji-Hua Dong
- Gang Wu
- Xiao-Rong Dong
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Affiliations: Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, P.R. China, Department of Nuclear Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, P.R. China, Medical Research Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, P.R. China

Copyright: © Gao et al. This is an open access article distributed under the terms of Creative Commons Attribution License.
Article Number: 61
|
Published online on: July 29, 2020

https://doi.org/10.3892/ol.2020.11922
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Abstract

The epidermal growth factor receptor‑tyrosine kinase inhibitors (EGFR‑TKIs) contribute to an increased response rate, compared with chemotherapy, in patients with inhibitor‑sensitive EGFR mutations. The present study evaluated the association between the maximum standardized uptake value (SUV_max) of 18F‑fluorodeoxyglucose positron emission tomography‑computed tomography (FDG PET/CT), as well as serum carcinoembryonic antigen (CEA) levels and EGFR mutations prior to treatment, in patients with non‑small cell lung cancer (NSCLC). Patients with histologically confirmed NSCLC (n=167), who underwent an 18F‑FDG PET/CT scan, EGFR mutation analysis and a serum CEA test participated in the present study. Multivariate logistic regression analysis was used to analyze predictors of EGFR mutations. Receiver‑operating characteristic (ROC) curve analysis was performed to determine the efficient cut‑off value. Survival rate analysis was evaluated according to SUV_max and EGFR mutation status. A decreased SUV_max and an increased CEA level was observed in patients with EGFR‑mutations, compared with patients with wild‑type primary lesions and metastatic lymph nodes. The exon 19 EGFR mutation was associated with increased SUV_max, compared with the exon 21 L858R mutation. The ROC analysis indicated that an 18F‑FDG PET/CT uptake SUV_max >11.5 may be a predictor of the wild‑type EGFR genotype and increased CEA levels (CEA >9.4 ng/ml) were associated with EGFR mutations. Furthermore, patients with no smoking history, low SUV_max of the primary tumor, metastatic lymph nodes and a high CEA level were significantly associated with EGFR mutation status. The results of the present study indicated that patients with advanced NSCLC, particularly Chinese patients, with decreased SUV_max and increased CEA levels are associated with EGFR mutations, which may serve as predictors for the EGFR‑TKI therapeutic response.

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