奥西替尼靶向治疗对非小细胞肺癌患者血清CEA、VEGF表达的影响

朱淑娟

[摘要] 目的 探讨奥西替尼靶向治疗对非小细胞肺癌（NSCLC）患者血清CEA、VEGF表达的影响。 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，按随机数字表法分为两组，每组各35例。对照组给予传统PC方案化疗，观察组给予奥西替尼靶向治疗。观察并比较两组疗效、毒副反应及血清CEA、VEGF表达情况。 结果 观察组RR和DCR分别为 85.71%、91.43%，均高于对照组的60.00%、71.43%（P<0.05）;治疗后，观察组血清CEA、VEGF水平均低于对照组（P<0.05）;观察组白细胞下降、肝功能损伤发生率低于对照组（P<0.05）;观察组1年生存率为77.14%、2年生存率为60.00%，均高于对照组的54.29%、34.29%（P<0.05）。 结论 奥西替尼靶向治疗非小细胞肺癌近远期疗效确切，可抑制CEA、VEGF表达，延长生存期。

[关键词] 奥西替尼;非小细胞肺癌;癌胚抗原;血管内皮生长因子

[中图分类号] R734.2          [文献标识码] B          [文章编号] 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

肺癌為当前全世界发病率及死亡率最高的恶性肿瘤，又以非小细胞肺癌（Non-small cell lung cancer，NSCLC）为主，约占80%，该病早期缺乏特异性症状与体征，约75%的患者一旦确诊往往已为中晚期，5年生存率极低[1]。美国癌症研究所建议针对失去手术指征的晚期NSCLC患者采取化疗治疗，其中PC方案（培美曲塞+顺铂）为当前最为成熟与经典的方案之一，可有效促进肿瘤细胞凋亡，但毒副反应较大，且会对机体免疫功能产生抑制作用，不利于机体功能康复。随着临床对NSCLC的深入研究发现，我国40%～50%的NSCLC中存在表皮生长因子受体（Epithelial growth factor receptor，EGFR）基因突变，而第1，2代EGFR络氨酸激酶抑制药（EGFR tyrosine kinase inhibitors，EGFR-TKIs）的出现开启了NSCLC精准医学时代，极大的延长了患者的生存期[2-3]。但因其获得性耐药的出现，在治疗6～12个月出现疾病的进展，且约60%的耐药均由T790M突变引起。奥西替尼属于第3代EGFR-TKIs，是当前唯一的治疗EGFR T790M突变阳性并对第1代EGFR-TKIs耐药的NSCLC药物[4]。动物实验表明，奥西替尼可抑制NSCLC小鼠肿瘤生长，提高免疫力，延长生存期[5-6]。但国内关于该药应用于临床的试验较少，据此，本研究重点探讨奥西替尼靶向治疗NSCLC的临床效果及安全性，现报道如下。