阿维A联合含铂方案对晚期非小细胞肺癌患者血癌胚抗原、表皮生长因子受体等及疗效的影响

Effect of chemotherapy with platinum and acitretin on serum carcinoembryonic antigen,epidermal growth factor receptor and clinical curative in patients with non-small cell lung cancer

目的应用阿维A联合含铂方案对晚期非小细胞肺癌患者进行治疗,了解化疗前后外周血中血癌胚抗原(CEA)、表皮生长因子受体(EGFR)、非小细胞相关抗原(CYFRA21-1)、神经特异烯醇化酶(NSE)的变化以及临床疗效。方法治疗组常规含铂类方案化疗后给予阿维A胶囊,对照组单纯采用含铂类方案化疗。3周后比较治疗前后CEA、EGFR、CYFRA21-1、NSE水平变化及患者临床症状改善率。结果化疗后治疗组血CEA、EGFR、NSE水平与化疗前相比显著下降(P<0.05),而CYFRA21-1治疗前后差异无统计学意义(P>0.05),对照组化疗前后EGFR水平变化差异有统计学意义(P<0.05),CEA、CYFRA21-1、NSE差异无统计学意义(P>0.05)。两组均无完全缓解病例,临床有效率(CR+PR)和疾病控制率(CR+PR+SD)治疗组分别为45.5%、100%,对照组分别为26.92%、76.92%;两组临床有效率差异无统计学意义(P>0.05),疾病控制率差异有统计学意义(P<0.05)。结论 EGFR水平治疗前后敏感性与CEA相似,是一个有价值的肺癌标记物,其水平变化有助于化疗疗效的评价;治疗组化疗后肿瘤标记物水平下降程度略高于对照组,疾病控制率也高于对照组;阿维A联合细胞毒疗法能提高非小细胞肺癌疾病控制率。

Objective To evaluate the change of serum tumor markers of carcinoembryonic antigen（CEA）,epidermal growth factor receptor（EGFR）,cytokeratin fragment antiogen 21-1（CYFRA21-1）,and neuron-specific enolase（NSE）,after combining acitretin and platinum in the treatment of non-small cell lung cancer（NSCLC）,and analyze the short term curative effects.Methods After chemotherapy with platinum,acitretin was given to the patients from the treatment group;the control group was given only the regular chemotherapy with platinum.Then after 3 weeks, compared with the concentrations change of serum CEA, EGFR, CYFRA21-1,and NSE before or after therapeutics and the melioration of clinical symptoms.Results In the treatment group,serum CEA,EGFR,NSE decreased significantly（P〈0.05）,while the serum CYFRA21-1 had obvious no differences in statistics; for the compare group, there was no statistical differences of serum CEA,CYFRA21-1,NSE concentrations between pre and post treatment（P〈0.05） except EGFR.There was no complete remission case in each of the two groups.The total effect rates [complete response（CR） and partial response（PR）] and disease control rates（DCR） were 45.45% and 100% respectively in the treatment group;while in the control group were 26.92% and 76.92% respectively.There was no statistical differences with the clinical effects （P〈0.05）,while the DCR had significant differences（P〈0.05） between the two groups.Conclusion EGFR has the similar action as CEA,which can be another valuable tumor marker of lung carcinoma; and the variation of it can be beneficial to value the clinical effects.The reduction of tumor markers level is high in patients of treatment group than those of control group;and the disease control benefits of treatment group is also priory to that of control group.Combined chemotherapy with retinoid acid can overcome the drug resistance of tumor cells effectively and can produce satisfactory curative effects.