观察化疗联合吉非替尼小分子靶向治疗晚期肺癌患者的疗效及对其血清CYFRA21-1的影响

Observation on the effect of chemotherapy combined with gefitinib small molecule targeted therapy for patients with advanced lung cancer and its influence on serum CYFRA21-1

目的探究对晚期肺癌患者采取化疗联合吉非替尼小分子靶向治疗的疗效及对其血清细胞角蛋白19片段抗原21-1(CYFRA21-1)的影响。方法106例晚期肺癌患者,根据治疗方案差异将其分成对照组(53例)和观察组(53例)。对照组采取化疗治疗,观察组采取化疗联合吉非替尼小分子靶向治疗。比较两组临床疗效及治疗前后血清炎性因子(白细胞介素-6、白细胞介素-8、白细胞介素-1β)、血清肿瘤标志物[CYFRA21-1、糖类抗原125(CA125)、糖类抗原199(CA199)]、肺功能(第1秒用力呼气容积占用力肺活量的比值、最大通气量、最大呼气中段流量)、生存质量。结果观察组临床缓解率显著高于对照组(86.79%VS 66.04%,P<0.05)。与本组治疗前比较,两组治疗后白细胞介素-6、白细胞介素-8、白细胞介素-1β水平均降低,且观察组治疗后白细胞介素-6(60.78±5.30)pg/ml、白细胞介素-8(73.86±10.02)pg/ml、白细胞介素-1β(58.57±20.51)pg/ml均低于对照组的(67.82±4.03)、(86.78±9.34)、(71.96±25.11)pg/ml(P<0.05)。与本组治疗前比较,两组治疗后CYFRA21-1、CA125、CA199水平均降低,且观察组治疗后CYFRA21-1(8.47±1.09)μg/L、CA125(38.43±5.12)kU/L、CA199(40.23±6.16)kU/L均低于对照组的(12.58±1.33)μg/L、(50.67±3.49)kU/L、(58.40±7.75)kU/L(P<0.05)。与本组治疗前比较,两组治疗后第1秒用力呼气容积占用力肺活量的比值、最大通气量、最大呼气中段流量均升高,且观察组高于对照组(P<0.05)。与本组治疗前比较,两组治疗后食欲下降、气促、咳嗽、疲倦、疼痛、痰中带血评分均降低,且观察组低于对照组(P<0.05)。结论化疗联合吉非替尼小分子靶向治疗晚期肺癌能够提高患者的临床疗效,降低血清血清炎性因子、相关肿瘤标志物水平,进一步改善肺功能。

Objective To explore the effect of chemotherapy combined with gefitinib small molecule targeted therapy for patients with advanced lung cancer and its influence on serum cytokeratin 19 fragments antigen 21-1(CYFRA21-1).Methods 106 patients with advanced lung cancer were divided into a control group(53 cases)and an observation group(53 cases)according to the difference of treatment regimen.The control group was treated with chemotherapy,and the observation group was treated with chemotherapy and gefitinib small molecule targeted therapy.Both groups were compared in terms of clinical efficacy and serum inflammatory factors(interleukin-6,interleukin-8,interleukin-1β),serum tumor markers[CYFRA21-1,carbohydrate antigen 125(CA125),carbohydrate antigen 199(CA199)],lung function(ratio of forced expiratory volume in one second to forced vital capacity,maximum ventilation volume,maximum mid-expiratory flow),quality of life before and after treatment.Results The clinical remission rate of the observation group was significantly higher than that of the control group(86.79%VS 66.04%,P<0.05).Compared with this group before treatment,the levels of interleukin-6,interleukin-8 and interleukin-1βin both groups decreased after treatment;after treatment,the observation group had interleukin-6 of(60.78±5.30)pg/ml,interleukin-8 of(73.86±10.02)pg/ml and interleukin-1βof(58.57±20.51)pg/ml,which were lower than(67.82±4.03),(86.78±9.34)and(71.96±25.11)pg/ml in the control group(P<0.05).Compared with this group before treatment,the levels of CYFRA21-1,CA125 and CA199 in both groups decreased after treatment;after treatment,the observation group had CYFRA21-1 of(8.47±1.09)μg/L,CA125 of(38.43±5.12)kU/L and CA199 of(40.23±6.16)kU/L,which were lower than(12.58±1.33)μg/L,(50.67±3.49)kU/L and(58.40±7.75)kU/L in the control group(P<0.05).Compared with this group before treatment,the ratio of forced expiratory volume in one second to forced vital capacity,maximum ventilation volume,maximum mid-expiratory flow increased in both groups after treatment,and the observation group was higher than the control group(P<0.05).Compared with this group before treatment,the scores of appetite loss,shortness of breath,cough,fatigue,pain and blood in sputum all decreased in both group after treatment,and the observation group was lower than the control group(P<0.05).Conclusion Chemotherapy combined with gefitinib small molecule targeted therapy for advanced lung cancer can improve the clinical efficacy of patients,reduce the levels of serum inflammatory factors and related tumor markers,and further improve lung function.