埃克替尼治疗晚期非小细胞肺癌的疗效观察及对机体免疫功能的影响  

The Efficacy of Icotinib in the Treatment of Advanced Non-Small Cell Lung Cancer and Its Influence on the Immune Function

作　　者：姜伟华[1] 高永山[1] 杨燕君[1] 王贵刚[1] 董跃华[1] 张振明[1] JIANG Weihua;GAO Yongshan;YANG Yanjun;WANG Guigang;DONG Yuehua;ZHANG Zhenming(Department of Thoracic Surgery, the First Affiliated Hospital of Hebei North University, Zhangjiakou 075000, China)

机构地区：[1]河北北方学院附属第一医院胸外科,张家口075000

出　　处：《标记免疫分析与临床》2021年第12期2078-2082,共5页Labeled Immunoassays and Clinical Medicine

基　　金：张家口市市级科技计划(编号:2021072D);河北省医学科学研究课题(编号:20211359)。

摘　　要：目的探讨埃克替尼治疗晚期非小细胞肺癌(NSCLC)的疗效及对机体免疫功能的影响。方法选取2018年1月至2020年12月我院晚期NSCLC患者96例,根据随机数字生成法分观察组、对照组,各48例。对照组予以TP方案,观察组加用埃克替尼,对比两组疗效、毒副反应、免疫功能(NK、CD3^(+)、CD4^(+)/CD8^(+))、血管新生指标[血管生成素-2(Ang-2)、血管内皮生长因子(VEGF)]、肿瘤标志物[细胞角蛋白19片段(CYFRA21-1)、癌胚抗原(CEA)、神经特异性烯醇化酶(NSE)]。结果两组腺癌疾病控制率、鳞癌疾病控制率对比,差异无统计学意义(P>0.05);组内不同病理类型的疾病控制率对比,差异无统计学意义(P>0.05);随治疗进行,NK、CD3^(+)、CD4^(+)/CD8^(+)呈降低趋势,但观察组高于对照组(P<0.05);血清Ang-2、VEGF、CYFRA21-1、CEA、NSE水平呈降低趋势,观察组低于对照组(P<0.05);两组不良反应主要集中在Ⅰ~Ⅱ级,恶心呕吐、低血压、肝功能异常、乏力、脱发,不良反应发生率对比,差异无统计学意义(P>0.05)。结论埃克替尼治疗晚期NSCLC能抑制血管新生,缓解病情,减轻化疗对机体免疫功能抑制作用,且对腺癌、鳞癌疗效相当,不良反应小,安全性高。Objective To explore the efficacy of icotinib in the treatment of advanced non-small cell lung cancer(NSCLC)and its effect on the immune function.Methods A total of 96 patients with advanced NSCLC in our hospital from January,2018 to December,2020 were selected and divided into the observation group and control group,with 48 cases in each group,according to the random number generation method.The control group was given TP,and the observation group was treated with icotinib in addition.The efficacy,side effects,immune function(NK,CD3^(+),CD4^(+)/CD8^(+)),angiogenesis indicators[angiogenin-2(Ang-2),vascular endothelial growth factor(VEGF)],tumor markers[cytokeratin 19 fragment(CYFRA21-1),carcinoembryonic antigen(CEA),and neurospecific enolase(NSE)]were compared between the two groups.Results There was no significant difference between the two groups of adenocarcinoma disease control rate and squamous cell carcinoma disease control rate(P>0.05);There was no statistically significant difference in the disease control rate of different pathological types in the same group(P>0.05);As the treatment progressed,NK,CD3^(+),CD4^(+)/CD8^(+)showed a decreasing trend,but the observation group was higher than the control group(P<0.05);Serum Ang-2,VEGF,CYFRA21-1,CEA,and NSE levels showed a decreasing trend,and the observation group was lower than the control group(P<0.05);Toxic and side effects of the two groups were mainly concentrated in gradesⅠtoⅡ,and there was no significant difference in the incidence of toxic and side effects of nausea and vomiting,hypotension,abnormal liver function,fatigue,and alopecia(P>0.05).Conclusion Icotinib,when used in the treatment of advanced NSCLC,can inhibit angiogenesis,alleviate the condition,and reduce the inhibitory effect of chemotherapy on the immune function.It has the similar curative effect on adenocarcinoma and squamous cell carcinoma,with a low toxicity and high safety.

关 键 词：埃克替尼 晚期 非小细胞肺癌 免疫功能 细胞角蛋白19片段 

分 类 号：R734.2[医药卫生—肿瘤]