表皮生长因子受体酪氨酸激酶抑制剂靶向治疗肺癌患者的临床效果及其对患者肺功能指标的影响

Clinical effect of EGFR-TKI targeted therapy for lung cancer and its influence on lung function indexes

目的探究表皮生长因子受体酪氨酸激酶抑制剂(EGFR-TKI)靶向治疗肺癌患者的临床效果及其对患者肺功能指标的影响。方法选取郴州市第一人民医院2018年1月—2020年12月收治的60例肺癌患者为研究对象,按照就诊顺序分为对照组与观察组,每组30例。对照组采用传统化疗进行干预,21 d为一个治疗周期;观察组采用EGFR-TKI靶向治疗联合传统化疗。比较2组患者治疗前后免疫功能指标[CD_(4)^(+)、CD_(8)^(+)、自然杀伤(NK)细胞]、肺功能指标[用力肺活量(FVC)、第1秒用力呼气容积(FEV_(1))、呼气流量峰值(PEF)、FEV_(1)/FVC],临床疗效,治疗前后肿瘤标志物指标[神经元特异性烯醇化酶(NSE)、细胞角质蛋白19片段抗原21-1(CYFRA21-1)、糖类抗原19-9(CA19-9)],并观察2组不良反应发生情况。结果治疗后,观察组总缓解率为76.67%,高于对照组的50.00%(χ^(2)=4.593,P=0.032)。治疗后2组CD_(4)^(+)、NK细胞高于治疗前,CD_(8)^(+)低于治疗前,且观察组CD_(4)^(+)、NK细胞高于对照组,CD_(8)^(+)低于对照组(P<0.05)。治疗后2组FVC、FEV_(1)、PEF、FEV_(1)/FVC高于治疗前,且观察组FVC、FEV_(1)、PEF高于对照组,FEV_(1)/FVC低于对照组(P<0.05)。治疗后2组NSE、CYFRA21-1、CA19-9低于治疗前,且观察组NSE、CYFRA21-1、CA19-9低于对照组(P<0.05)。对照组不良反应总发生率为86.67%,与观察组的73.33%比较,差异无统计学意义(χ^(2)=1.667,P=0.197)。结论EGFR-TKI靶向治疗应用于肺癌,在改善患者免疫功能及肺功能方面有着明显效果,且安全性较高。

Objective To investigate the clinical effect of epidermal growth factor receptor tyrosine kinase inhibitor(EGFR-TKI)in targeted treatment of lung cancer and its influence on lung function indexes of patients.Methods Sixty cases of lung cancer patients admitted to Chenzhou First People's Hospital from January 2018 to December 2020 were selected as the experimental subjects,and they were divided into control group and observation group according to the time of treatment.30 cases in each group.Control group were treated with traditional chemotherapy and observation group were treated with EGFR-TKI targeted therapy combined with traditional chemotherapy.Immune function indexes[CD_(4)^(+),CD_(8)^(+),natural killer(NK)cell],lung function indexes[forced vital capacity(FVC),forced expiratory volume in 1 second(FEV_(1)),peak expiratory flow(PEF),FEV_(1)/FVC],clinical effect,tumor marker indexes[neuron specific enolase(NSE),cyto-keratin 19 fragment antigen 21-1(CYFRA21-1),carbohydrate antigen 19-9(CA19-9)]were compared between the two groups before and after treatment and the incidence of adverse reactions were observed between the two groups.Results The total remission rate in observation group(76.67%)was higher than that in control group(50.00%)(χ^(2)=4.593,P=0.032).After treatment,CD_(4)^(+) and NK cell in two groups were higher than those before treatment,while CD_(8)^(+) was lower than that before treatment(P<0.05);after treatment,CD_(4)^(+) and NK cell in the observation group were higher than those in the control group,while CD_(8)^(+)was lower than that in the control group(P<0.05).After treatment,FVC,FEV_(1),PEF,FEV_(1)/FVC in two groups were higher than those before treatment,and FVC,FEV_(1),PEF in the observation group were higher than those in the control group,while FEV_(1)/FVC was lower than that in the control group(P<0.05).After treatment,NSE,CYFRA21-1,CA19-9 in two groups were lower than those before treatment,and NSE,CYFRA21-1,CA19-9 in the observation group were lower than those in the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the observation group and the control group(86.67%vs.73.33%,χ^(2)=1.667,P=0.197).Conclusion EGFR-TKI targeted therapy for lung cancer has an outstanding effect in improving the immune function and lung function of patients,with definite curative effect and no increase in toxic and side effects.