通过回顾性分析不同驱动基因肺癌患者的血清癌胚抗原(CEA)水平，探讨CEA在不同驱动基因肺癌患者中的差异性。

选择2015年9月至2018年12月唐都医院呼吸与危重症医学科经治的210例肺癌患者，分别采用电化学发光免疫分析法和探针扩增阻滞突变系统聚合酶链反应法检测CEA水平及基因突变状况，分析不同驱动基因肺癌患者的CEA水平。

存在基因突变的肺癌患者以女性为主(52.46%)，而无基因突变的肺癌患者则以男性为主(67.39%)，差异具有统计学意义(P＝0.004)。基因突变的肺癌患者CEA水平11.43(4.32～46.82) ng/ml明显高于无基因突变的肺癌患者4.52(2.07～14.87) ng/ml(P<0.001)，而E19Del、L858R、KRAS、EML4-ALK和ROS1，以及组合突变和少见突变等各靶点的不同肺癌患者CEA水平之间并没有明显差异性(P均>0.05)。将基因检测阳性的肺癌患者按EGFR组、KRAS组、EML4-ALK组及ROS1组进一步分析，发现KRAS组以男性为主(76.47%)，EML4-ALK组则以女性为主(90.91%)，这两组之间存在明显的性别差异性(P＝0.007)；而四组在年龄及CEA水平方面并没有明显差异性(P均>0.05)。

肺癌患者的CEA水平对基因检测阳性和阴性具有一定的预测价值，但是它对基因检测阳性肺癌患者的敏感靶点并没有预测价值。

Level of the carcinoembryonic antigen(CEA) was studied in lung cancer patients with different driving gene, to explore the difference of their CEA .

All 210 cases of patients with lung cancer were recruited in Department of Respiratory and Critical Care Medicine Tang Du Hospital. CEA was measured by Electro-Chemiluminescence Immunoassay (ECLI). And their mutations were measured by amplification refractory mutation system (ARMS). Then the CEA of lung cancer patients with different driving gene was analyzed.

The majority of lung cancer patients with gene mutation were female (52.46%), while those without gene mutation were mainly male (67.39%). The difference was statistically significant (P=0.004) in them. The CEA level in lung cancer patients with gene mutation [11.43 (4.32~46.82) ng/ml] was significantly higher than that in patients without gene mutation [4.52 (2.07~14.87) ng/ml] (P<0.001), while there was no significant difference in CEA levels among patients with different mutations such as e19del, L858R, KRAS, EML4-ALK and ROS1, as well as combination mutation and rare mutation (P>0.05). Then, the lung cancer patients with positive gene detection were divided into EGFR group, KRAS group, EML4-ALK group and ROS1 group. Further analysis found that the majority of lung cancer patients in KRAS group were male (76.47%), while EML4-ALK group was mainly female (90.91%). There was significant gender difference between the KRAS group and EML4-ALK group (P=0.007), but there was no significant difference in age and CEA level among the four groups (P>0.05).

Although the serum CEA can probably serve as marker of prediction mutations in patients with lung cancer, it has no predictive value for sensitive targets for genetically positive lung cancer patients.