表皮生长因子受体酪氨酸激酶抑制剂治疗晚期表皮生长因子受体突变型非小细胞肺癌的效果及对免疫功能的影响

Epidermal Growth Factor Receptor Tyrosine Kinase

目的:探讨表皮生长因子受体酪氨酸激酶抑制剂(EGFR-TKI)治疗晚期表皮生长因子受体(EGFR)突变型非小细胞肺癌的效果及对免疫功能的影响。方法:选取2021年1月-2022年1月菏泽医学专科学校附属医院收治的80例晚期EGFR突变型非小细胞肺癌患者,使用随机数字表法将其分为观察组(n=40)及对照组(n=40)。两组均接受盐酸吉西他滨和顺铂治疗,此基础上,对照组加用多西紫杉醇治疗,观察组加用吉非替尼治疗。对比两组客观有效率、疾病控制率、肿瘤标志物指标、免疫功能指标及不良反应发生率。结果:观察组客观有效率及疾病控制率均高于对照组(P<0.05)。治疗前,两组癌胚抗原(CEA)、鳞状细胞癌抗原(SCCA)、神经元特异性烯醇化酶(NSE)、细胞角蛋白19片段抗原21-1(CYFRA21-1)、糖类抗原125(CA125)及血管内皮生长因子(VEGF)水平比较,差异均无统计学意义(P>0.05);治疗后,两组以上各项指标均降低,且观察组均低于对照组(P<0.05)。治疗前,两组CD3+、CD4+、CD8+水平比较,差异均无统计学意义(P>0.05);治疗后,两组CD3+、CD4+水平均升高,观察组均高于对照组,CD8+水平均降低,观察组低于对照组(P<0.05)。观察组不良反应发生率(5.00%)低于对照组(20.00%)(P<0.05)。结论:EGFR-TKI可显著降低晚期EGFR突变型非小细胞肺癌患者肿瘤标志物的表达水平、改善其免疫功能,减少不良反应的发生,安全有效。

Objective:To investigate the effect of epidermal growth factor receptor tyrosine kinase inhibitor(EGFR-TKI)in the treatment of advanced epidermal growth factor receptor(EGFR)mutant non-small cell lung cancer and its influence on immune function.Method:A total of 80 patients with advanced EGFR mutant non-small cell lung cancer who were admitted to Affiliated Hospital of Heze Medical College from January 2021 to January 2022 were selected and divided into an observation group(n=40)and a control group(n=40)according to random number table method.Both groups were treated with Gemcitabine Hydrochloride and Cis-platin.On this basis,the control group was additionally treated with Docetaxel,and the observation group was additionally treated with Gefitinib.The objective response rate,disease control rate,tumor marker indicators,immune function indicators and the incidence of adverse reactions were compared between the two groups.Result:The objective response rate and disease control rate in the observation group were higher than those in the control group(P<0.05).Before treatment,the levels of carcinoembryonic antigen(CEA),squamous cell carcinoma antigen(SCCA),neuron specific enolase(NSE),cyto-keratin 19 fragment antigen 21-1(CYFRA21-1),carbohydrate antigen 125(CA125)and vascular endothelial growth factor(VEGF)were not significantly differences between the two groups(P>0.05).After treatment,all the above indicators in the two groups decreased,and those in the observation group were lower than those in the control group(P<0.05).Before treatment,there were not significantly differences in the levels of CD3+,CD4+,CD8+between the two groups(P>0.05).After treatment,the levels of CD4+,CD8+in both groups increased,and those in the observation group were higher than those in the control group,while the levels of CD8+in both groups decreased,that in the observation group was lower than that in the control group(P<0.05).The incidence of adverse reactions in the observation group(5.00%)was lower than that in the control group(20.00%)(P<0.05).Conclusion:EGFR-TKI can significantly reduce the expression level of tumor markers in patients with advanced EGFR mutant non-small cell lung cancer,improve their immune function and reduce the occurrence of adverse reactions,which is safe and effective.