奧西替尼靶向治療對非小細胞肺癌患者血清CEA、VEGF表達的影響

朱淑娟

[摘要] 目的 探討奧西替尼靶向治療對非小細胞肺癌（NSCLC）患者血清CEA、VEGF表達的影響。 方法 收集我院自2014年1月～2016年1月收治的70例晚期NSCLC患者，按隨機數字表法分為兩組，每組各35例。對照組給予傳統PC方案化療，觀察組給予奧西替尼靶向治療。觀察并比較兩組療效、毒副反應及血清CEA、VEGF表達情況。 結果 觀察組RR和DCR分別為 85.71%、91.43%，均高于對照組的60.00%、71.43%（P<0.05）;治療后，觀察組血清CEA、VEGF水平均低于對照組（P<0.05）;觀察組白細胞下降、肝功能損傷發生率低于對照組（P<0.05）;觀察組1年生存率為77.14%、2年生存率為60.00%，均高于對照組的54.29%、34.29%（P<0.05）。 結論 奧西替尼靶向治療非小細胞肺癌近遠期療效確切，可抑制CEA、VEGF表達，延長生存期。

[關鍵詞] 奧西替尼;非小細胞肺癌;癌胚抗原;血管內皮生長因子

[中圖分類號] R734.2 ? ? ? ? ?[文獻標識碼] B ? ? ? ? ?[文章編號] 1673-9701（2019）14-0068-04

[Abstract] Objective To investigate the effect of oxitinib targeted therapy on serum CEA and VEGF in patients with non-small cell lung cancer（NSCLC）. Methods 70 patients with advanced NSCLC who were admitted in our hospital from January 2014 to January 2016 were enrolled in the study. They were divided into two groups according to the random number table， with 35 cases in each group. The control group received chemotherapy with traditional PC regimen， and the observation group received oxitinib targeted therapy. The efficacy， toxicity and side effects， and serum CEA and VEGF expression between two groups were observed and compared. Results The RR and DCR of the observation group were 85.71% and 91.43%， respectively， which were higher than 60.00% and 71.43% of the control group （P<0.05）. After treatment， the serum CEA and VEGF levels in the observation group were lower than those in the control group （P<0.05）. The incidence of leukopenia and liver function damage in the observation group was lower than that in the control group（P<0.05）. The 1-year survival rate of the observation group was 77.14%， and the 2-year survival rate was 60.00%， which was higher than that of the control group （54.29%， 34.29%）， P<0.05. Conclusion Oxytinib is effective in the treatment of non-small cell lung cancer in the short-term and long-term. It can inhibit the expression of CEA and VEGF and prolong survival.

[Key words] Oxytinib; Non-small cell lung cancer; Carcinoembryonic antigen; Vascular endothelial growth factor

肺癌為當前全世界發病率及死亡率最高的惡性腫瘤，又以非小細胞肺癌（Non-small cell lung cancer，NSCLC）為主，約占80%，該病早期缺乏特異性癥狀與體征，約75%的患者一旦確診往往已為中晚期，5年生存率極低[1]。美國癌癥研究所建議針對失去手術指征的晚期NSCLC患者采取化療治療，其中PC方案（培美曲塞+順鉑）為當前最為成熟與經典的方案之一，可有效促進腫瘤細胞凋亡，但毒副反應較大，且會對機體免疫功能產生抑制作用，不利于機體功能康復。隨著臨床對NSCLC的深入研究發現，我國40%～50%的NSCLC中存在表皮生長因子受體（Epithelial growth factor receptor，EGFR）基因突變，而第1，2代EGFR絡氨酸激酶抑制藥（EGFR tyrosine kinase inhibitors，EGFR-TKIs）的出現開啟了NSCLC精準醫學時代，極大的延長了患者的生存期[2-3]。但因其獲得性耐藥的出現，在治療6～12個月出現疾病的進展，且約60%的耐藥均由T790M突變引起。奧西替尼屬于第3代EGFR-TKIs，是當前唯一的治療EGFR T790M突變陽性并對第1代EGFR-TKIs耐藥的NSCLC藥物[4]。動物實驗表明，奧西替尼可抑制NSCLC小鼠腫瘤生長，提高免疫力，延長生存期[5-6]。但國內關于該藥應用于臨床的試驗較少，據此，本研究重點探討奧西替尼靶向治療NSCLC的臨床效果及安全性，現報道如下。