EGFR–TKI 靶向治疗对老年突变优势晚期 肺癌患者肿瘤标志物及生存的影响

Effects of Targeted EGFR–TKI Therapy on Tumor Markers and Survival in Elderly Patients with MutantDominant Advanced Lung Cancer

摘要:

〔摘 要〕 目的：探讨应用表皮生长因子受体（EGFR）– 络氨酸激酶抑制剂（TKI）靶向治疗对 EGFR 突变状态未 明但具突变优势的老年晚期肺癌患者的血清肿瘤标志物及生存状况的影响。 方法：选取平潭综合实验区医院 2019 年 10 月至 2021 年 5 月期间收治的 20 例老年晚期肺腺癌患者，患者均为 EGFR 突变状态未明但具备突变优势特征。随 机将患者分两组，各 10 例。观察组患者采取 EGFR–TKI（吉非替尼）靶向治疗，对照组患者使用白蛋白紫杉醇与顺 铂双药化疗。两组患者治疗 3 个月后，评价临床疗效，并采集患者治疗前后的血清标本，测定其癌胚抗原（CEA）， 细胞角蛋白 19 片段（CYFRA21–1），鳞状细胞癌相关抗原（SCC）的指标水平；患者均随访 1 年，以卡氏功能状态 （KPS）评分评价生存质量。 结果：两组患者治疗总有效率比较，差异无统计学意义（P ＞ 0.05）。治疗后两组患者 CEA、CYFRA21–1、SCC 均有不同程度降低，且治疗 3 个月观察组患者 CEA、CYFRA21–1、SCC 均低于对照组， 差异具有统计学意义（P ＜ 0.05）。治疗后两组患者生存质量评分均有不同程度提高，且治疗 3 个月观察组患者生 存质量评分均高于对照组，差异具有统计学意义（P ＜ 0.05）。观察组患者生存 8 例（80.00 %），高于对照组 2 例 （20.00 %），差异具有统计学意义（P ＜ 0.05）。 结论：应用 EGFR–TKI 靶向治疗 EGFR 突变状态未明但具备突变 优势特征老年晚期肺癌患者效果较好，可有效降低患者肿瘤标志物水平，提高其生存质量。

Abstract:

〔Abstract〕 Objective To investigate the effect of epidermal growth factor receptor (EGFR) -tyrosine kinase inhibitor (TKI) targeting therapy on serum tumor markers and survival in elderly patients with advanced lung cancer with unknown EGFR mutation status but dominant mutation. Methods Twenty elderly patients with advanced lung adenocarcinoma admitted to Pingtan Comprehensive Experimental Area Hospital from October 2019 to May 2021 were selected. All patients had unknown EGFR mutation status but had dominant mutation characteristics. The patients were randomly divided into two groups with 10 cases each. Observation group received EGFR-TKI (gefitinib) targeted therapy, and control group received albumin paclitaxel and cisplatin chemotherapy. After 3 months of treatment, clinical efficacy was evaluated, and serum samples were collected before and after treatment to determine the index levels of carcinoembryonic antigen (CEA), cytokeratin 19 fragment (CYFRA21-1) and squamous cell carcinoma associated antigen (SCC). All patients were followed up for 1 year and their quality of life was evaluated by KPS scores. Results There was no significant difference in the total effective rate between the two groups (P > 0.05). After treatment, CEA, CYFRA21-1 and SCC in 2 groups were decreased to varying degrees, and after 3 months of treatment, CEA, CYFRA21-1 and SCC in observation group were lower than those in control group, the differences were statistically significant (P < 0.05). After treatment, the quality of life scores of the two groups were improved to varying degrees, and after 3 months of treatment, the observation group was higher than the control group, the differences were statistically significant (P < 0.05). The survival rate of 8 patients (80.00%) in the observation group was higher than that of 2 patients (20.00%) in the control group, and the difference was statistically significant (P < 0.05). Conclusion The application of EGFR-TKI targeting in the treatment of elderly advanced lung cancer with unknown EGFR mutation status but dominant mutation characteristics has certain effect, good downregulation of tumor marker values, satisfactory improvement in survival therapy and significant improvement in survival.