吉非替尼联合NP化疗对EGFR敏感突变的非小细胞肺癌患者免疫状态及预后的影响  

Effects of Gefitinib Combined with NP Chemotherapy on Immune Status and Prognosisof Patients with Non-small Cell Lung Cancer with EGFR Sensitive Mutations

作　　者：魏祯瑶 皇甫娟[1] 张慧辉[1] Wei Zhenyao;Huangfu Juan;Zhang Huihui(Jiaozuo People′s Hospital,Jiaozuo 454002 China)

机构地区：[1]焦作市人民医院,河南焦作454002

出　　处：《锦州医科大学学报》2023年第5期47-51,共5页Journal of Jinzhou Medical University

基　　金：2020年度河南省医学科技攻关计划联合共建立项项目,项目编号:LHGJ20200835。

摘　　要：目的 探讨存在表皮生长因子受体(epidermal growth factor receptor, EGFR)敏感突变的非小细胞肺癌(non-small cell lung cancer, NSCLC)患者采用吉非替尼联合NP化疗方案治疗的临床疗效,并分析其对免疫状态及预后的影响。方法 依据随机数字表法将焦作市人民医院2019年3月至2022年5月收治的72例EGFR敏感突变的NSCLC患者分为两组,各36例。对照组采用NP化疗方案治疗,观察组在对照组基础上加用吉非替尼治疗,均持续治疗3个周期。比较两组临床疗效、血清肿瘤标志物[糖类抗原125(carbohydrate antigen, CA125)、神经元特异性烯醇化(neuron specific alkenation, NSE)、癌胚抗原(carcinoembryonic antigen, CEA)、细胞角蛋白19片段(cytokeratin 19 fragmen, CYFRA21-1)]、免疫状态[自然杀伤细胞(natural killer cell, NK)、CD3~+、CD4~+、CD8~+、CD4~+/CD8~+]及毒副反应发生情况;并随访6个月,统计两组患者预后情况。结果 观察组临床缓解率较高,且观察组血清肿瘤标志物水平均较低(P<0.05);治疗3个周期时,观察组免疫状态指标改善均优于对照组(P<0.05);两组毒副反应发生率比较,差异无统计学意义(P>0.05);随访6个月后,观察组生存率高于对照组(P<0.05)。结论 吉非替尼联合NP化疗方案可提高EGFR敏感突变的NSCLC患者临床缓解率,降低CEA、CA125、NSE、CYFRA21-1水平,改善患者免疫状态,且具有良好安全性,有利于改善患者预后。Objective To investigate the clinical efficacy of gefitinib combined with NP chemotherapy in the treatment of non-small cell lung cancer(NSCLC)patients with epidermal growth factor receptor(EGFR)sensitive mutations,and analyze its impact on immune status and prognosis.Methods 72 cases of NSCLC patients with EGFR sensitive mutations admitted to Jiaozuo People′s Hospital from March 2019 to May 2022 were divided into two groups according to the random number table method,with 36 cases in each group.The control group was treated with NP chemotherapy regimen,while the observation group was treated with gefitinib on the basis of the control group,both of which lasted for 3 cycles.The clinical efficacy,serum tumor markers[carbohydrate antigen 125(CA125),neuron specific alkenation(NSE),carcinoembryonic antigen(CEA),and cytokeratin 19 fragment(CYFRA21-1)],immune status[natural killer cell(NK),CD3+,CD4+,CD8+,and CD4+/CD8+]and the occurrence of side effects were compared between the two groups.The patients were followed up for 6 months,and the prognosis of the two groups was statistically analyzed.Results The clinical remission rate of the observation group was higher,and the levels of serum tumor markers in the observation group were lower(P<0.05);after 3 cycles of treatment,the improvement of immune status indexes in the observation group was better than that in the control group(P<0.05);there was no statistically significant difference in the incidence of toxic and side effects between the two groups(P>0.05);after 6 months of follow-up,the survival rate of the observation group was higher than that of the control group(P<0.05).Conclusion Gefitinib combined with NP chemotherapy can improve the clinical remission rate of NSCLC patients with EGFR sensitive mutations,reduce the levels of CEA,CA125,NSE,and CYFRA21-1,improve the immune status of patients,and has good safety,which is conducive to improving the prognosis of patients.

关 键 词：EGFR敏感突变非小细胞肺癌 吉非替尼 长春瑞滨 顺铂 免疫状态 

分 类 号：R734.2[医药卫生—肿瘤]