安罗替尼联合TC化疗方案治疗驱动基因阴性晚期肺腺癌患者的效果

Effect of Androtinib Combined with TC Chemotherapy Regimen on Patients with Advanced Lung Adenocarcinoma with Driver Gene-Negative Advanced Lung Adenocarcinoma

目的分析安罗替尼联合TC化疗方案治疗驱动基因阴性晚期肺腺癌患者的效果。方法选取2019年1至2020年12月许昌市人民医院收治的106例驱动基因阴性晚期肺腺癌患者作为研究对象,按照随机数表法分为化疗组和联合组,各53例。化疗组接受TC化疗方案治疗,联合组接受安罗替尼联合TC化疗方案治疗。比较两组客观缓解率(ORR)、治疗前及治疗3个周期后血清肿瘤标志物[癌胚抗原(CEA)、细胞角蛋白19片段(CYERA21-1)、鳞状细胞癌抗原(SCCA)、糖类抗原153(CA153)]水平、血清基质金属蛋白酶(MMP)-2、MMP-9水平及微小RNA-498(miR-498)、微小RNA339-5p(miR-339-5p)相对表达量、卡氏功能状态评估量表(KPS)评分、无瘤生存时间。结果联合组ORR高于化疗组(P<0.05)。治疗前两组血清CEA、CYERA21-1、SCCA、CA153水平比较,差异无统计学意义(P>0.05);治疗3个周期后联合组血清CEA、CYERA21-1、SCCA、CA153水平低于化疗组(P<0.05)。治疗前两组血清MMP-2、MMP-9水平、miR-498、miR-339-5p相对表达量比较,差异无统计学意义(P>0.05);治疗3个周期后,联合组血清MMP-2、MMP-9水平低于对照组,miR-498、miR-339-5p相对表达量高于对照组(P<0.05)。治疗前两组KPS评分比较,差异无统计学意义(P>0.05);治疗3个周期后联合组KPS评分高于化疗组(P<0.05)。随访1 a后,联合组失访1例,化疗组失访2例。联合组中位无瘤生存时间为9个月,高于化疗组(7个月)(P<0.05)。结论安罗替尼联合TC化疗方案治疗驱动基因阴性晚期LAC患者疗效确切,可抑制肿瘤细胞浸润、增殖,延长患者生存期,提高生活质量。

Objective To analyze the effect of androtinib combined with TC chemotherapy in the treatment of patients advanced lung adenocarcinoma with driver gene-negative advanced lung.Methods A total of 106 patients with advanced lung adenocarcinoma with negative driving gene who were admitted to Xuchang People’s Hospital from January 2019 to December 2020 were selected as the study subjects.They were divided into chemotherapy group and combination group according to random number table method,with 53 patients in each group.The chemotherapy group was treated with TC chemotherapy regimen,and the combined group was treated with androtinib combined with TC chemotherapy regimen.The objective response rate(ORR),the levels of serum tumor markers[carcinoembryonic antigen(CEA),cytokeratin 19 fragment(CYERA21-1),squamous cell carcinoma antigen(SCCA),carbohydrate antigen 153(CA153)],the levels of serum matrix metalloproteinase-2,MMP-9,and the relative expression of microRNA-498(miR-498),microRNA339-5p(miR-339-5p)score of KPS and tumor-free survival time were compared between the two groups before and after treatment.Results The ORR of combined group was higher than that of chemotherapy group(P<0.05).There were no differences in the levels of CEA,CYERA21-1,SCCA and CA153 between the two groups before treatment(P>0.05).After 3 cycles of treatment,the serum CEA,CYERA21-1,SCCA and CA153 levels in the combined group were lower than those in the chemotherapy group(P<0.05).Before treatment,there were no differences between the two groups in the levels of serum MMP-2,MMP-9,and the relative expression of miR-498 and miR-339-5p(P>0.05).After 3 cycles of treatment,the levels of serum MMP-2 and MMP-9 in the combination group were lower than those in the control group,and the relative expression of miR-498 and miR-339-5p in the combination group were higher than that in the control group(P<0.05).There was no difference in KPS score between the two groups before treatment(P>0.05).After 3 cycles of treatment,the KPS score of the combined group was higher than that of the chemotherapy group(P<0.05).After 1 year of follow-up,one case was lost in the combination group and two cases in the chemotherapy group.The median tumor-free survival time of the combined group was 9 months,which was higher than that of the chemotherapy group(7 months)(P<0.05).Conclusion Androtinib combined with TC chemotherapy is effective in the treatment of advanced LAC patients with negative driving gene,which can inhibit the infiltration and proliferation of tumor cells,prolong the survival period of patients,and improve the quality of life.