苦参碱联合AP方案化疗治疗EGFR突变阴性中晚期肺腺癌患者临床观察  

Clinical observation of matrine combined with AP regimen chemotherapy in the treatment of patients with EGFR mutation-negative advanced lung adenocarcinoma

作　　者：屈蕾蕾[1] 边雨田[1] 张衡中[1] QU Leilei;BIAN Yutian;ZHANG Hengzhong(First People's Hospital of Baiyin in Gansu Province,Baiyin 730900,China)

机构地区：[1]甘肃省白银市第一人民医院,白银市730900

出　　处：《内科》2018年第6期827-829,855,共4页Internal Medicine

基　　金：甘肃省中医药管理局科研项目(GZK-2014-55)

摘　　要：目的探讨采用苦参碱联合AP方案化疗治疗对EGFR突变阴性中晚期肺腺癌患者血清癌胚抗原(CEA)、糖类抗原125(CA125)及细胞角蛋白19片段(CYFRA21-1)水平的影响。方法选取Ⅲb-Ⅳ期EGFR突变阴性肺腺癌患者94例,随机分为观察组和对照组,每组47例。观察组患者采用苦参碱+AP方案化疗,对照组患者采用单纯AP方案化疗。分别于化疗后3个月、6个月及12个月检测比较两组患者的CEA、CA125及CYFRA21-1水平。结果最终完成随访患者共80例,其中观察组患者46例,对照组患者34例。观察组与对照组患者的血清CEA、CA125、CYFRA21-1水平比较,差异有统计学意义(P <0. 05),两组患者在治疗后不同时间(3个月、6个月、12个月)的CEA、CA125、CYFRA21-1水平存在显著差异,治疗方案与治疗时间存在交互效应(P <0. 05)。结论采用苦参碱联合AP化疗方案治疗EGFR突变阴性的中晚期肺腺癌患者,可发挥协同增效作用,增强化疗效果,且随着治疗时间的延长,协同增效效应逐步增强,能有效降低肿瘤细胞的多重耐药性。Objective To investigate the effects of matrine combined with AP regimen chemotherapy on serum carcinoembryonic antigen(CEA),carbohydrate antigen 125(CA125) and cytokeratin 19(CYFRA21-1) levels in patients with EGFR mutation-negative advanced lung adenocarcinoma. Methods 94 patients with stage IIIb-IV EGFR mutation-negative lung adenocarcinoma were randomly divided into observation group and control group,with 47 cases in each group. Patients in the observation group received chemotherapy with matrine AP regimen chemotherapy,and patients in the control group received chemotherapy with AP alone. The levels of CEA,CA125 and CYFRA21-1 were compared between the two groups at 3 months,6 months and 12 months after chemotherapy. Results A total of 80 patients were followed up,including 46 patients in the observation group and 34 patients in the control group. The levels of serum CEA,CA125 and CYFRA21-1 in the observation group and the control group were significantly different(P < 0. 05). There were significant differences in CEA,CA125,and CYFRA21-1levels between the two groups at different times(3 months,6 months,and 12 months). There was an interaction between the treatment regimen and treatment time(P < 0. 05). Conclusion Using matrine combined with AP regimen chemotherapy to treat EGFR mutation-negative advanced lung adenocarcinoma patients can play a synergistic effect and enhance the effect of chemotherapy. With the prolongation of treatment time,the synergistic effect is gradually enhanced,which can effectively reduce the multi-drug resistance of tumor cells.

关 键 词：肺肿瘤 腺癌 苦参碱 培美曲塞 顺铂 基因 erbB-1 

分 类 号：R563[医药卫生—呼吸系统]