EGFR-TKI联合化疗对晚期非小细胞肺癌患者血清IGF-1和AGR2水平的影响

目的观察表皮生长因子受体-酪氨酸激酶抑制剂(EGFR-TKI)联合化疗对非小细胞肺癌(NSCLC)患者化疗前后血清胰岛素样生长因子1(IGF-1)和前梯度蛋白2(AGR2)水平变化的影响,探讨IGF-1和AGR2能否作为评估NSCLC化疗疗效及预后的指标。方法选取68例晚期NSCLC患者给予EGFR-TKI联合化疗为试验组,并以30例健康人群为健康对照组,采用酶联免疫吸附试验(ELISA)分别测定化疗前、化疗3周后血清IGF-1、AGR2水平。采用Kanplan-Meier法分析血清IGF-1、AGR2水平变化对预后的影响。结果(1)EGFR-TKI联合化疗疾病控制率(DCR)为52.9%;(2)试验组治疗前血清IGF-1水平为(329.35±88.13)μg/L,明显高于健康对照组的(146.36±41.27)μg/L(P0.01),试验组治疗前血清AGR2水平为(16.72±6.23)ng/mL,高于健康对照组的(4.38±2.17)ng/mL(P0.01);治疗后血清IGF-1为(211.53±52.31)μg/L、AGR2水平为(9.72±3.56)ng/mL,均比治疗前明显降低(均P0.01);NSCLC患者血清IGF-1与AGR2水平呈正相关(r=0.489,P0.01);(3)治疗有效组患者血清IGF-1水平为(128.62±48.24)μg/L、AGR2水平为(7.22±4.27)ng/mL,分别较治疗前IGF-1(334.23±82.11)μg/L]、AGR2(18.43±6.17)ng/mL]明显下降(均P0.01)。Kanplan-Meier分析显示,治疗后血清IGF-1、AGR2水平的高低对预后有明显影响。结论 IGF-1、AGR2水平在评估EGFR-TKI联合化疗对晚期NSCLC的疗效及预后有着潜在的临床价值。

Effect of EGFR-TKI combined with chemotherapy on serum IGF-1 and AGR2 levels in patients with advanced non-small cell lung cancer

Objective To observe the effect of EGFR‐TKI combined with chemotherapy on the changes of serum insulin‐like growth factor1(IGF‐1)and anterior gradient‐2(AGR2)levels in the patients with advanced non‐small cell lung cancer(NSCLC) ,and to investigate whether IGF‐1 and AGR2 can serve as a potential indicator of the prognosis and efficacy of chemotherapy in NSCLC . Methods Sixty‐eight patients with advanced NSCLC were selected as the experimental group treated by EGFR‐TKI combined chemotherapy and 30 healthy people served as the healthy control group .(treatment group) .The levels of serum IGF‐1 and AGR2 before chemotherapy and at 3 weeks after chemotherapy were detected by ELISA .The influence of serum IGF‐1 and AGR2 levels on the prognosis was analyzed by using Kanplan‐Meier method .Results (1)The disease control rate(DCR)in the EGFR‐TKI com‐bined chemotherapy was 52 .9% ;(2)the level of serum IGF‐1 before treatment in the experimental group was (329 .35 ± 88 .13)μg/L ,which was significantly higher than (146 .36 ± 41 .27)μg/L in the healthy control group(P<0 .01);the level of serum AGR2 in experimental group was(16 .72 ± 6 .23)ng/mL ,which was significantly higher than (4 .38 ± 2 .17)ng/mL in the healthy control group(P<0 .01);serum levels of IGF‐1 and AGR2 after treatment were(211 .53 ± 52 .31)μg/L and (9 .72 ± 3 .56)ng/mL respec‐tively ,which were significantly lower than those before treatment (P<0 .01);serum IGF‐1 and AGR2 in NSCLC patients were pos‐itively correlated(r=0 .489 ,P<0 .01);(3)serum levels of IGF‐1 and AGR2 after chemotherapy were(128 .62 ± 48 .24)μg/L and (7 .22 ± 4 .27)ng/mL respectively ,which were obviously lower than(334 .23 ± 82 .11)μg/L and(18 .43 ± 6 .17)ng/mL before chem‐otherapy(all P<0 .01) .The Kanplan‐Meier analysis revealed that serum IGF‐1 and AGR2 levels in advanced NSCLC had an obvi‐ous influence on the prognosis .Conclusion Serum IGF‐l and AGR2 levels may have a potential clinical value to assess the therapeu‐tic efficacy of EGFR‐TKI combined chemotherapy and prognosis in advanced NSCLC .