吉非替尼靶向治疗对晚期EGFR基因突变NSCLC患者表皮生长因子及免疫功能的影响研究

Study the effects of gefitinib targeted therapy on epidermal growth factor and immune function in patients with EGFR-mutant advanced NSCLC

目的探讨吉非替尼靶向治疗对晚期表皮生长因子受体(EGFR)基因突变非小细胞肺癌(NSCLC)患者表皮生长因子及免疫功能的影响。方法60例晚期EGFR基因突变NSCLC患者,以等量电脑随机法分成A组和B组,每组30例。A组患者开展常规化疗治疗,B组患者在A组基础上加用吉非替尼靶向治疗。对比两组治疗前后血清和胸腔积液EGFR水平、免疫球蛋白指标[免疫球蛋白A(IgA)、免疫球蛋白G(IgG)、免疫球蛋白M(IgM)]水平及临床疗效、不良反应发生情况。结果治疗后,B组血清EGFR(15.48±1.28)ng/L显著低于A组的(18.71±1.51)ng/L,差异具有统计学意义(t=8.937,P=0.000<0.05);治疗后,B组胸腔积液EGFR(5.00±0.52)ng/L显著低于A组的(6.37±0.59)ng/L,差异具有统计学意义(t=9.541,P=0.000<0.05)。治疗前,两组IgA、IgG、IgM水平对比差异无统计学意义(P>0.05);治疗后,B组IgA、IgG、IgM分别为(1.88±0.31)、(5.57±0.49)、(1.64±0.17)g/L,均高于A组的(1.56±0.57)、(5.07±0.54)、(1.46±0.15)g/L,差异有统计学意义(P<0.05)。B组临床总有效率83.33%显著高于A组的60.00%,差异有统计学意义(χ^(2)=4.022,P=0.045<0.05)。B组不良反应发生率26.67%高于A组的20.00%,但差异无统计学意义(χ^(2)=0.373,P=0.542>0.05)。结论吉非替尼靶向治疗可改善晚期EGFR基因突变NSCLC患者的免疫功能,并降低EGFR水平,疗效确切,具有推广价值。

Objective To discuss the effects of gefitinib targeted therapy on epidermal growth factor and immune function in patients with epidermal growth factor receptor(EGFR)-mutant advanced non-small cell lung cancer(NSCLC).Methods A total of 60 patients with EGFR-mutant advanced NSCLC were divided into group A and group B according to equivalent computer random method,with 30 cases in each group.Patients in group A were treated with conventional chemotherapy,and patients in group B were treated with gefitinib targeted therapy on the basis of group A.Both groups were compared in terms of EGFR levels in serum and pleural effusion,immunoglobulin indexes[immunoglobulin A(IgA),immunoglobulin G(IgG),immunoglobulin M(IgM)]before and after treatment,clinical efficacy,and occurrence of adverse reactions.Results After treatment,the serum EGFR of(15.48±1.28)ng/L in group B was significantly lower than that of(18.71±1.51)ng/L in group A,and the difference was statistically significant(t=8.937,P=0.000<0.05).After treatment,EGFR of(5.00±0.52)ng/L in pleural effusion in group B was significantly lower than that of(6.37±0.59)ng/L in group A,and the difference was statistically significant(t=9.541,P=0.000<0.05).Before treatment,there was no statistically significant difference in IgA,IgG and IgM levels between the two groups(P>0.05).After treatment,IgA,IgG and IgM in group B were(1.88±0.31),(5.57±0.49)and(1.64±0.17)g/L,which were higher than those of(1.56±0.57),(5.07±0.54)and(1.46±0.15)g/L in group A,and the difference were statistically significant(P<0.05).The total clinical effective rate of group B was 83.33%,which was significantly higher than that of 60.00%of group A,and the difference was statistically significant(χ^(2)=4.022,P=0.045<0.05).The incidence of adverse reactions in group B was 26.67%,which was higher than that of 20.00%in group A,but the difference was not statistically significant(χ^(2)=0.373,P=0.542>0.05).Conclusion Gefitinib targeted therapyhas definite curative effect on patients with EGFR-mutant advanced NSCLC,and can improve the immune function and reduce the level of EGFR of patients,which has popularization value.