吉非替尼对晚期非小细胞肺癌患者化疗中癌胚抗原、CYFRA21-1及CA125表达水平的影响

Effect of gefitinib on the expression levels of CEA,CYFRA21-1 and CA125 in patients with advanced non-small cell lung carcinoma

目的探讨吉非替尼对晚期非小细胞肺癌(NSCLC)患者化疗中癌胚抗原、细胞角蛋白19片段抗原(CYFRA)21-1、糖类抗原(CA)125表达水平的影响。方法前瞻性选取2018年1月至2021年10月亳州市人民医院收治的晚期NSCLC患者86例,根据随机数字表法将其分为两组,每组各43例。对照组给予顺铂+紫杉醇化疗,观察组在对照组治疗的基础上给予吉非替尼治疗,两组均治疗4个周期,记录癌胚抗原、CYFRA21-1及CA125表达变化情况。结果观察组的总有效率为81.40%,显著优于对照组(55.81%),差异有统计学意义(P<0.05)。两组治疗后的血清癌胚抗原、CYFRA21-1及CA125含量均显著低于治疗前,观察组癌胚抗原、CYFRA21-1及CA125含量为(34.20±11.84)ng/mL、(1.87±0.33)ng/mL、(23.85±7.44)U/mL,均显著低于对照组[(54.01±10.88)ng/mL、(2.56±0.41)ng/mL、(43.10±5.87)U/mL],差异均有统计学意义(P<0.05)。两组治疗期间的不良反应分别为恶心呕吐、肝肾损害、白细胞减少、血小板降低,组间对比差异无统计学意义(P>0.05)。两组均随访至2021年12月,观察组的总生存时间与无瘤生存时间为(26.24±4.12)个月、(19.15±3.77)个月,均显著长于对照组(18.14±4.08)个月、(12.11±4.11)个月,差异均有统计学意义(P<0.05)。结论吉非替尼应用于晚期NSCLC患者化疗中可显著提高治疗效果,并明显延长患者的生存时间,且不会增加不良反应的发生,其作用机制可能与抑制机体癌胚抗原、CYFRA21-1及CA125的表达有关。

Objective To investigate the effect of gefitinib on the expression of carcinoembryonic antigen(CEA),cytokeratin fragment antigen(CYFRA)21-1 and carbohydrate antigen(CA)125 in patients with advanced non-small cell lung carcinoma(NSCLC).Methods From January 2018 to October 2021,86 patients with advanced NSCLC who treated in Bozhou People's Hospital were prospectively selected as subjects and equally divided into two groups according to the random number table method.The control group were treated with cisplatin combined with paclitaxel,the observation group were treated with gefitinib on the basis of the control group.The two groups were treated for 4 cycles,and the changes of CEA,CYFRA21-1 and CA125 were recorded.Results The total effective rates of the observation group were 81.40%,which were significantly better than that of the control group(55.81%),the difference was statistically significant(P<0.05).The toxic and side effects during the treatment were nausea and vomiting,liver and kidney damage,leukopenia and thrombocytopenia,and there were no significant difference compared between the two groups(P>0.05).The levels of serum CEA,CYFRA21-1 and CA125 in the two groups after treatment were significantly lower than those before treatment,and the levels of serum CEA,CYFRA21-1 and CA125 in the observation group were(34.20±11.84)ng/mL,(1.87±0.33)ng/mL,and(23.85±7.44)U/mL,which were significantly lower than those in the control group[(54.01±10.88)ng/mL,(2.56±0.41)ng/mL,(43.10±5.87)U/mL],the differences were statistically significant(P<0.05).During the followed-up period to December 2021,the total survival time and tumor-free survival time of the observation group were(26.24±4.12)months and(19.15±3.77)months,which were significantly longer than those of the control group(18.14±4.08)months,(12.11±4.11)months,the differences were statistically significant(P<0.05).Conclusion The application of gefitinib to chemotherapy in patients with advanced NSCLC can significantly improve the therapeutic effect and significantly prolong the survival time of patients without increasing the occurrence of toxic and side effects.Its mechanism of action may be related to the inhibition of the expression of CEA,CYFRA21-1 and CA125 in the body.