吉非替尼在表皮生长因子受体突变晚期非小细胞肺癌患者中的应用效果

Application effect of gefitinib in patients with epidermal growth factor receptor mutation advanced non-small cell lung cancer

目的探讨吉非替尼在表皮生长因子受体(EGFR)突变晚期非小细胞肺癌(NSCLC)患者中的应用效果。方法根据治疗方法的不同将90例EGFR突变NSCLC患者分为对照组和观察组,每组45例,对照组患者接受化疗,观察组患者在对照组的基础上联合吉非替尼治疗。比较两组患者的临床疗效、血清肿瘤标志物[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)、癌胚抗原(CEA)]水平、免疫功能指标[免疫球蛋白G(IgG)、免疫球蛋白M(IgM)、免疫球蛋白A(IgA)]、炎性因子[白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)]水平及预后。结果观察组患者的总有效率为68.89%,高于对照组患者的42.22%,差异有统计学意义(P<0.05)。治疗前,两组患者的NSE、CYFRA21-1、CEA、IgG、IgM、IgA、IL-6、TNF-α水平比较,差异均无统计学意义(P>0.05)。治疗后,两组患者的NSE、CYFRA21-1、CEA、IgG、IgM、IgA、IL-6、TNF-α水平均低于本组治疗前,观察组患者的NSE、CYFRA21-1、CEA、IL-6、TNF-α水平均低于对照组,IgG、IgM、IgA水平均高于对照组,差异均有统计学意义(P<0.05)。观察组患者的平均总生存期(OS)和平均无进展生存期(PFS)均明显长于对照组,差异均有统计学意义(P<0.01)。结论吉非替尼可有效降低EGFR突变晚期NSCLC患者的血清肿瘤标志物和炎性因子水平,改善免疫功能,提高临床疗效,延长患者生存期,值得临床推广应用。

Objective To investigate the effect of gefitinib in patients with epidermal growth factor receptor(EGFR)mutation advanced non-small cell lung cancer(NSCLC).Method A total of 90 patients with EGFR-mutated NSCLC were divided into control group and observation group according to different treatment methods,with 45 cases in each group.Patients in the control group received chemotherapy,and patients in the observation group were treated with gefitinib on the basis of the control group’s regimen.The clinical efficacy,serum tumor markers[neuron specific enolase(NSE),cyto-keratin 19 fragment antigen 21-1(CYFRA21-1),carcinoembryonic antigen(CEA)]levels,immune functional indicators[immunoglobulin G(IgG),immunoglobulin M(IgM),immunoglobulin A(IgA)],inflammatory factors[interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)]levels and prognosis were compared between the two groups.Result The total response rate of the observation group was 68.89%,which was higher than 42.22%of the control group,and the difference was statistically significant(P<0.05).Before the treatment,there were no significant differences in the levels of NSE,CYFRA21-1,CEA,IgG,IgM,IgA,IL-6,and TNF-αbetween the two groups(P>0.05).After the treatment,the levels of NSE,CYFRA21-1,CEA,IgG,IgM,IgA,IL-6,and TNF-αin the two groups were lower than those before the treatment,the levels of NSE,CYFRA21-1,CEA,IL-6,and TNF-αin the observation group were lower than those in the control group,while the levels of IgG,IgM,and IgA were higher than those in the control group,and the differences were statistically significant(P<0.05).The median overall survival(OS)and progression-free survival(PFS)of the observation group were longer than those of the control group,and the differences were statistically significant(P<0.01).Conclusion Gefitinib could effectively reduce the levels of serum tumor markers and inflammatory factors in advanced NSCLC patients with EGFR mutation,then improve the immune function and clinical curative effect,prolong patients’survival,and thus can be popularized and applied in clinical practice.