表皮生长因子受体突变型转移性NSCLC的靶向治疗效果及对SCC、CYFRA21-1、CEA表达的影响

目的分析靶向治疗在表皮生长因子受体(EGFR)突变型转移性非小细胞肺癌(NSCLC)的临床疗效以及对鳞状细胞癌抗原(SCC)、细胞角蛋白19片段(CYFRA21-1)及癌胚抗原(CEA)的影响。方法前瞻性将2018年5月至2019年7月在延安大学附属医院接受治疗的98例NSCLC患者纳入研究,采取随机数字表法分为观察组和对照组2组,每组各49例。对照组给予常规放疗,观察组给予表皮生长因子酪氨酸激酶抑制剂(EGFR-TKI)靶向治疗。评估2组患者临床疗效;通过血清生化检验测定2组患者治疗前和治疗3个月后SCC、CEA及CYFRA21-1指标水平变化;记录2组患者治疗后不良反应。分析CEA、SCC、CYFRA21-1与临床疗效的相关性。结果观察组治疗总有效率和疾病控制率分别为79.59%、95.92%,均高于对照组的55.10%、81.63%,差异有统计学意义(P<0.05)。2组患者治疗3个月后SCC、CEA及CYFRA21-1水平相较于治疗前均明显下降,且观察组SCC、CEA及CYFRA21-1水平分别为(1.13±0.41)、(3.14±0.93)、(74.24±11.13)μg/L,明显低于对照组[(1.75±0.49)、(3.94±1.02)、(112.59±21.52)μg/L],差异有统计学意义(P<0.05)。观察组患者在腹泻、皮疹、贫血、呕吐等不良症状总发生率为6.12%,显著优于对照组的16.33%,差异有统计学意义(P<0.05)。CEA、SCC、CYFRA21-1与病情缓解呈正相关,CEA、SCC、CYFRA21-1表达水平越低,临床疗效越好(P<0.05)。结论EGFR突变型转移性NSCLC采用EGFR-TKI靶向治疗后,SCC、CYFRA21-1、CEA水平可得到有效改善,提高疗效的同时不良症状较少,有着较佳的应用价值。

Targeted therapeutic effect of epidermal growth factor receptor mutant metastatic NSCLC and its effect on expression of SCC,CYFRA21-1 and CEA

Objective To analyze the clinical effect of targeted therapy in EGFR mutant NSCLC and its effect on SCC,CYFRA21-1 and CEA.Methods Ninty-eight NSCLC patients who were treated in Affiliated Hospital of Yan'an University from May 2018 to July 2019 were included in the study and divided into observation group and control group by random number table method,each group 49 cases.The control group were received conventional radiotherapy,and the observation group were received EGFR-TKI targeted therapy.The clinical effects were evaluated.The levels of SCC,CEA and CYFRA21-1 were measured by serum biochemical test before and after three months treatment,and the adverse reactions were recorded.The correlation between CEA,SCC,CYFRA21-1 and clinical efficacy was analyzed.Results After three months treatment,the total effective rate of treatment and disease control rate in the observation group were 79.59%and 95.92%,respectively,which were higher than those in the control group(55.10%and 81.63%),the differences were statistically significant(P<0.05).After three months treatment,the levels of SCC,CEA and CYFRA21-1 in the two groups were significantly lower than before treatment.The levels of SCC,CEA and CYFRA21-1 in the observation group after treatment were(1.13±0.41),(3.14±0.93),(74.24±11.13)μg/L,which were significantly lower than those in the control group[(1.75±0.49),(3.94±1.02),(112.59±21.52)μg/L],the differences were statistically significant(P<0.05).The total incidence of adverse symptoms such as diarrhea,skin rash,anemia,and vomiting in the observation group was 6.12%,which was significantly better than 16.33%in the control group,and the difference was statistically significant(P<0.05).CEA,SCC,and CYFRA21-1 were positively correlated with disease remission.The lower the expression level of CEA,SCC,and CYFRA21-1,the better the clinical efficacy(P<0.05).Conclusion after targeted treatment with EGFR-TKI,the levels of SCC,CYFRA21-1 and CEA can be effectively improved,with less adverse symptoms and better application value.