吉非替尼靶向治疗对非小细胞肺癌患者表皮生长因子及免疫功能的影响

Effects of Gefitinib Targeted Therapy on Epidermal Growth Factor and Immune Function in Patients with Non-small Cell Lung Cancer

目的:研究吉非替尼靶向治疗对晚期EGFR基因突变非小细胞肺癌(non-small cell lung cancer,NSCLC)患者表皮生长因子及免疫功能的影响.方法:选取2016年1月到2017年8月在医院就诊的晚期EGFR基因突变的NSCLC患者120例,按简单随机分组法分为对照组及观察组.对照组采用常规化疗方案,观察组在对照组基础上使用吉非替尼,以28d为一个周期,共治疗4个周期.统计两组患者疗效、Ⅲ、Ⅳ度化疗毒副反应发生率及一年生存率,检测T淋巴细胞水平、免疫球蛋白指标、血清及胸腔积液中EGFR水平.结果:观察组治疗疾病控制率、治疗有效率均高于对照组(P<0.05);观察组治疗后CD3^+、CD4^+、CD4^+/CD8^+均高于对照组,CD8+低于对照组(P<0.05);观察组治疗后免疫球蛋白指标均高于对照组(P<0.05);观察组治疗后血清、胸腔积液中表皮生长因子受体(epidermal growth factor receptor,EGFR)水平均低于对照组(P<0.05).结论:吉非替尼靶向治疗晚期EGFR基因突变的NSCLC可显著降低EGFR水平并改善免疫功能.

Objective: To study the effects of gefitinib targeted therapy on epidermal growth factor and immune function in patients with late stage EGFR gene mutation non-small cell lung cancer (NSCLC). Methods: 120 patients with late stage EGFR gene mutation NSCLC who were admitted to the hospital from January 2016 to August 2017 were selected and divided into control group and observation group according to simple random grouping method. Control group was given conventional chemotherapy regimen, and observation group was given gefitinib on the basis of control group, and they were treated for 4 cycles with a cycle of 28d. The efficacy, incidence rate of toxic and side effects of III and IV chemotherapy were counted in the two groups. The levels of T lymphocytes, immunoglobulins, serum and pleural effusion EGFR were detected. Results: The disease control rate and effective rate of treatment in observation group were higher than those in control group (P<0.05). The CD3^+, CD4^+ and CD4^+/CD8^+ levels in observation group after treatment were higher than those in control group while the CD8+ level was lower than that in control group (P<0.05). The immunoglobulins indexes in observation group after treatment were higher than those in control group (P<0.05). The levels of epidermal growth factor receptor (EGFR) in serum and pleural effusion after treatment in observation group were lower than those in control group (P<0.05). Conclusions: Gefitinib targeted therapy can significantly reduce EGFR level and improve immune function in the treatment of late stage EGFR gene mutation NSCLC.