克唑替尼胶囊联合NP方案治疗晚期非小细胞肺癌的效果及对血清NSE、CEA、Cyfra21-1水平的影响  

Effect of Crizotinib Capsules Combined with NP Regimen in the Treatment of Advanced Non-small Cell Lung Cancer and Its Influence on the Levels of Serum NSE,CEA and Cyfra21-1

作　　者：钱伟玲 吴沙沙 赵红梅 徐硕 QIAN Wei-ling;WU Sha-sha;ZHAO Hong-mei;XU Shuo(Department of Clinical Medicine,Hainan Cancer Hospital,Haikou 570000,China)

机构地区：[1]海南省肿瘤医院临床药学部,海口570000

出　　处：《临床误诊误治》2022年第10期26-32,共7页Clinical Misdiagnosis & Mistherapy

基　　金：海南省卫生计生行业科研项目(18A200142)。

摘　　要：目的探讨克唑替尼胶囊联合NP方案(顺铂联合注射用酒石酸长春瑞滨)治疗非小细胞肺癌(NSCLC)的效果,并分析患者治疗前后血清神经元特异性烯醇化酶(NSE)、癌胚抗原(CEA)、细胞角蛋白19可溶性片段(CYFRA21-1)水平变化及与治疗效果的关系。方法选取2018年10月-2021年2月收治的NSCLC 62例,按治疗方法分为观察组和对照组各31例。对照组采用克唑替尼胶囊治疗,观察组采用NP方案联合克唑替尼胶囊治疗。比较2组疾病控制率、毒副反应发生率、生存质量、治疗后棘皮动物微管相关蛋白样4(EML4)-ALK阳性率,治疗前后血清NSE、CEA、Cyfra21-1水平,分析治疗前后血清肿瘤标志物差值与临床疗效的相关性。结果观察组疾病进展率低于对照组,疾病控制率高于对照组(P<0.05)。治疗2个周期后,观察组EML4-ALK阳性率低于对照组(P<0.05)。治疗2个周期后,2组血清NSE、CEA、Cyfra21-1水平低于治疗前,观察组低于对照组,且观察组ΔNSE、ΔCEA、ΔCyfra21-1小于对照组(P<0.05)。ΔNSE、ΔCEA、ΔCyfra21-1与临床疗效呈负相关(r=-0.611、-0.648、-0.432,P<0.05)。观察组生存质量优于对照组(P<0.05)。2组毒副反应发生率比较差异无统计学意义(P>0.05)。结论克唑替尼胶囊联合NP方案治疗NSCLC,可有效降低EML4-ALK阳性率、肿瘤标志物水平,提升疗效,改善患者生存质量,且安全性高。Objective To investigate the effect of Crizotinib Capsules combined with NP regimen(cisplatin combined with vinorelbine tartrate for injection)in the treatment of non-small cell lung cancer(NSCLC),and to analyze the serum neuron-specific enolase before and after treatment(NSE),carcinoembryonic antigen(CEA),cytokeratin 19 soluble fragment(Cyfra21-1)level changes and their relationship with the therapeutic effect.Methods We selected 62 patients with NSCLC admitted from October 2018 to February 2021,and divide them into the observation group(n=31)and the control group(n=31)according to the treatment method.The control group was treated with Crizotinib Capsules,and the observation group was treated with NP regimen+Crizotinib Capsules.The disease control rate(DCR),the incidence of toxic and side effects,the quality of life,the positive rate of Echinoderm microtubule-associated protein-like 4(EML4)-anaplastic lymphoma kinase(ALK)after treatment,and the serum NSE,CEA,Cyfra21-1 levels before and after treatment were compared between the two groups.The correlation between the difference of serum tumor markers before and after treatment and the clinical efficacy was analyzed.Results The disease progression rate of the observation group was lower than that of the control group,and the disease control rate was higher than that of the control group(P<0.05).After 2 cycles of treatment,the positive rate of EML4-ALK in the observation group was lower than that in the control group(P<0.05).After 2 cycles of treatment,the levels of serum NSE,CEA,Cyfra21-1 in the two groups were lower than those before treatment,and lower in the observation group than in the control group,andΔNSE,ΔCEA,ΔCyfra21-1 in the observation group were lower than those in the control group(P<0.05).ΔNSE,ΔCEA,ΔCyfra21-1 were negatively correlated with clinical efficacy(r=-0.611,-0.648,-0.432,P<0.05).The quality of life in the observation group was better than that in the control group(P<0.05).There was no significant difference in the incidence of toxic a

关 键 词：非小细胞肺癌 间变性淋巴瘤激酶-酪氨酸激酶抑制剂 克唑替尼胶囊 NP方案 神经元特异性烯醇化酶 癌胚抗原 细胞角蛋白19可溶性片段 EML4-ALK阳性率 

分 类 号：R734.2[医药卫生—肿瘤]