表皮生长因子受体酪氨酸激酶抑制剂治疗晚期非小细胞肺癌的效果及对免疫功能的调节作用  

Efficacy of epidermal growth factor receptor tyrosine kinase inhibitor in the treatment of patients with advanced non-small cell lung cancer and its regulatory effect on immune function

作　　者：任晓辉[1] 张霞[1] 于剑飞[2] 田瑞芬[1] 宋霞[1] Ren Xiaohui;Zhang Xia;Yu Jianfei;Tian Ruifen;Song Xia(Second Department of Respiratory Medicine,Shanxi Provincial Cancer Hospital,Taiyuan 030013,China;Department of Respiration&Radiation Therapy Head and Neck Comprehensive Ward,Shanxi Provincial Cancer Hospital,Taiyuan 030013,China)

机构地区：[1]山西省肿瘤医院呼吸二科,太原030013 [2]山西省肿瘤医院放射治疗头颈综合病区,太原030013

出　　处：《中国临床实用医学》2021年第1期12-17,共6页China Clinical Practical Medicine

摘　　要：目的探讨表皮生长因子受体酪氨酸激酶抑制剂(EGFR-TKI)治疗晚期非小细胞肺癌(NSCLC)患者的效果及对免疫功能的调节作用。方法选取2017年1月至2019年12月山西省肿瘤医院呼吸二科收治的100例经病理诊断为晚期(ⅢA~Ⅳ期)NSCLC的患者,男60例,女40例,年龄(58.94±12.33)岁,年龄范围为35~72岁。根据基因检测结果,依据患者基因突变情况分为EGFR-TKI组(n=48)、克唑替尼组(n=7)与联合治疗组(n=45),EGFR-TKI组采用EGFR-TKI治疗,克唑替尼组采用克唑替尼治疗,联合治疗组采用多西他赛联合顺铂治疗。比较三组患者的治疗效果、不良反应发生情况、淋巴细胞亚群[表面抗原分化簇3(CD3^(+))、表面抗原分化簇4(CD4^(+))、表面抗原分化簇8(CD8^(+))、CD4^(+)/CD8^(+)]和生活质量[健康调查简表(SF-36)评分、卡氏行为能力状况量表(KPS)评分]。结果 EGFR-TKI组的有效率(68.8%)、疾病控制率(87.5%)和克唑替尼组的有效率(71.4%)、疾病控制率(85.7%)高于联合治疗组[(31.1%)、(44.4%)],差异有统计学意义(P<0.05)。三组患者不良反应发生率比较,差异无统计学意义(P>0.05)。治疗后,EGFR-TKI组CD3^(+)[(49.67±7.35)%]、CD4^(+)[(42.00±5.17)%]、CD4^(+)/CD8^(+)(1.97±0.51)高于治疗前[(28.73±4.92)%]、[(24.16±3.90)%、(1.30±0.49)],克唑替尼组CD3^(+)[(51.21±7.72)%]、CD4^(+)[(40.79±4.37)%]、CD4^(+)/CD8^(+)(2.01±0.48)高于治疗前[(28.42±4.52)%]、[(23.85±3.73)%、(1.30±0.52)],联合治疗组CD3^(+)[(41.05±6.37)%]、CD4^(+)[(34.52±4.41)%]、CD4^(+)/CD8^(+)(1.67±0.45)高于治疗前[(28.62±5.36)%]、[(23.65±3.66)%、(1.28±0.53)],三组患者的CD8^(+)[(16.71±1.79)%、(15.90±1.93)%、(21.28±2.40)%]均低于治疗前[(26.44±3.20)%、(26.42±3.11)%、(26.32±3.05)%];治疗后,EGFR-TKI组的SF-36评分[(84.26±6.70)分]、卡氏评分[(86.29±7.92)分]和克唑替尼组的SF-36评分[(82.85±5.72)分]、卡氏评分[(87.84±7.28)分]均高于联合治疗组[(67.19±6.33)分、(73.56±8.16)分],差�Objective To investigate the effect of epidermal growth factor receptor tyrosine kinase inhibitor(EGFR-TKI)in the treatment of advanced non-small cell lung cancer(NSCLC)and its regulation on immune function.Methods Between January 2017 and December 2019,100 patients with advanced(stageⅢA to stageⅣ)NSCLC admitted to the Second Department of Respiratory Medicine,Shanxi Cancer Hospital were selected,including 60 males and 40 females,aged(58.94±12.33)years old,ranging from 35 to 72 years old.According to the results of genetic testing,patients were divided into the EGFR-TKI group(n=48),Crizotinib group(n=7)and combined treatment group(n=45).Patients in the EGFR-TKI group were treated with EGFR-TKI,patients in the Crizotinib group were treated with Crizotinib,and patients in the combined treatment group were treated with docetaxel combined with cisplatin.Treatment effects,adverse reactions,and lymphocyte subsets[cluster of differentiation 3(CD3^(+)),cluster of differentiation 4(CD4^(+)),cluster of differentiation 8(CD8^(+)),CD4^(+)/CD8^(+)]and quality of life[medical outcomes study short form-36(SF-36),Karnofsky performance scale(KPS)]were compared among the three groups.Results The total effective rate(68.8%),disease control rate(87.5%)and the total effective rate(71.4%)and disease control rate(85.7%)in the EGFR-TKI group were higher than those in the combined treatment group[(31.1%)and(44.4%)],and the difference was statistically significant(P<0.05).There was no significant difference in the incidence of adverse reactions among the three groups(P>0.05).After treatment,CD3^(+)[(49.67±7.35)%],CD4^(+)[(42.00±5.17)%]and CD4^(+)/CD8^(+)(1.97±0.51)in the EGFR-TKI group were higher than those before treatment[(28.73±4.92)%,(24.16±3.90)%and(1.30±0.49)];CD3^(+)[(51.21±7.72)%],CD4^(+)[(40.79±4.37)%]and CD4^(+)/CD8^(+)(2.01±0.48)in the Crizotinib group were higher than those before treatment[(28.42±4.52)%,(23.85±3.73)%and(1.30±0.52)];CD3^(+)[(41.05±6.37)%],CD4^(+)[(34.52±4.41)%]and CD4^(+)/CD8^(+)(1.67±0.45

关 键 词：非小细胞肺癌 表皮生长因子受体酪氨酸激酶抑制剂 克唑替尼 免疫功能 

分 类 号：R734.2[医药卫生—肿瘤]