吉非替尼联合GP化疗方案治疗晚期非小细胞肺癌的效果及对血清CEA、SCC、NSE、CYFRA21-1水平的影响

Efficacy of Gefitinib Combined with GP Chemotherapy in the Treatment of Advanced Non-small Cell lung Cancer and Its Effect on the Serum CEA,SCC, NSE and CYFRA21-1 Levels

目的:研究吉非替尼联合吉西他滨和顺铂(GP)化疗方案治疗晚期非小细胞肺癌的效果及对血清癌胚抗原(Carcinoembbryonic antigen,CEA)、鳞状细胞癌相关抗原(Squamous cell carcinoma,SCC)、神经元特异烯醇化酶(Neuron-specific enolase,NSE)、细胞角蛋白19片段(Cytokeratin-19-fragment,CYFRA21-1)水平的影响。方法:选取2016年6月~2018年6月我院收治的晚期非小细胞肺癌患者110例,采用随机数字表法将患者分为两组,每组55例。对照组患者给予GP化疗方案,观察组在对照组的基础上给予吉非替尼。比较两组患者的临床治疗效果,治疗前后血清肿瘤标志物水平和生活质量的变化以及不良反应发生情况。结果:治疗后,观察组疾病控制率为86.67%,对照组为74.55%,观察组显著高于对照组(P<0.05);两组治疗后血清CEA、SCC、NSE和CYFRA21-1水平均较治疗前显著下降,且观察组以上指标均显著低于对照(P<0.05);两组治疗后FACT-L各项评分包括躯体状况、社会家庭状况、情感状况、肺癌特异性模块和功能状况评分均较治疗前显著升高,且观察组以上指标均显著高于对照(P<0.05)。治疗期间,观察组患者白细胞减少、血小板减少、肝肾功能异常的发生率显著低于对照组(P<0.05),两组贫血、恶心呕吐的发生率比较无统计学差异(P>0.05)。结论:与GP化疗方案相比,吉非替尼联合GP化疗方案可更显著提高晚期非小细胞肺癌患者的治疗效果,改善其生活质量,且安全性较高,可能与其降低血清CEA、SCC、NSE和CYFRA21-1水平有关。

Objective: To study the efficacy of gefitinib combined with gemcitabine and cisplatin(GP) chemotherapy in the treatment of advanced non-small cell lung cancer and its effect on serum carcinoembryonic antigen(CEA), squamous cell carcinoma(SCC),Effects of neuron-specific enolase(NSE) and Cytokeratin-19-fragment(CYFRA21-1) levels. Methods: 110 patients with advanced non-small cell lung cancer admitted to our hospital from June 2016 to June 2018 were selected. The patients were divided into two groups with random number table method, with 55 patients in each group. The control group was given GP chemotherapy, and the observation group was given gefitinib on the basis of the control group. The clinical effects, changes of serum tumor markers and quality of life before and after treatment, as well as the occurrence of adverse reactions were compared between the two groups. Results: After treatment, the disease control rate was 86.67% in the observation group and 74.55% in the control group, which was significantly higher than that in the control group(P<0.05). There was no significant difference in CEA, SCC, NSE and CYFRA21-1 levels in the two groups before treatment(P>0.05). After treatment, the above indicators were significantly decreased in two groups, and in the observation group was significantly lower than the control group(P<0.05). The FACT-L scores of the two groups before treatment included physical condition, social family status, emotional status, lung cancer specific module and functional status, and there was no significant difference(P>0.05). After treatment, these scores were significantly increased in two groups, and the observation group was significantly higher than the control group(P<0.05). During the treatment period, the incidence of leukopenia, thrombocytopenia, liver and kidney dysfunction in the observation group was significantly lower than that in the control group(P<0.05), and there was no statistical difference in the incidence of anemia, nausea and vomiting between the two groups(P>0.05). Conclusion: Compared with GP chemotherapy, gefitinib combined with GP chemotherapy can significantly improve the treatment of patients with advanced non-small cell lung cancer, improve their quality of life, and have higher safety, which may reduce serum CEA, SCC, NSE and CYFRA21-1 level is related.