Ren Hui, Hu Yang, Xie Tao, Jin Caibao, Hu Yanping, Yang Bin
Department of Thoracic Oncology, Hubei Cancer Hospital, Wuhan, Hubei 430079, P.R. China.
Department of Head and Neck Radiotherapy, Hubei Cancer Hospital, Wuhan, Hubei 430079, P.R. China.
Oncol Lett. 2019 Oct;18(4):4167-4175. doi: 10.3892/ol.2019.10762. Epub 2019 Aug 16.
Changes of epidermal growth factor receptor (EGFR) and cytokeratin fragment antigen 21-1 (CYFRA21-1) in patients with advanced non-small cell lung cancer (NSCLC) before and after gefitinib treatment were observed to explore the significance of such changes. A total of 175 patients with advanced NSCLC who were admitted to Hubei Cancer Hospital from July 2012 to October 2015 were collected and divided into two groups: the control group (85 patients who received conventional chemotherapy) and the experimental group (90 patients treated with gefitinib combined with chemotherapy). The serum expression levels of EGFR and CYFRA21-1 were detected by enzyme-linked immunosorbent assay (ELISA). The therapeutic efficacy and 3-year survival of the two groups were compared, and the factors affecting the survival of the patients were analyzed. The total effective rate and local effective rate of the experimental group were significantly higher than those of the control group (P<0.05). Before treatment, no significant difference was detected in the levels of EGFR and CYFRA21-1 between the two groups (P>0.05). After treatment, the expression levels of EGFR and CYFRA21-1 in the two groups were significantly lower than those before treatment (P<0.05). According to the 3-year survival rate, the experimental group was divided into the survival group and the non-survival group. Single factor analysis was performed on the general data, showing that the influencing factors of the survival include the KPS score, smoking history, number of lesions, pathological stage, EGFR, and CYFRA21-1. Gefitinib can bring significantly improved therapeutic efficacy, lower expression levels of EGFR and CYFRA21-1, and longer survival time for patients with advanced NSCLC. Indicators including confirmed smoking history, a KPS score less than or equal to 60 points, multiple lesions, pathological stage IV, high expression of EGFR and CYFRA21-1, are important factors affecting the survival of patient with advanced NSCLC.
观察晚期非小细胞肺癌（NSCLC）患者吉非替尼治疗前后表皮生长因子受体（EGFR）和细胞角蛋白片段抗原21-1（CYFRA21-1）的变化，以探讨其变化的意义。收集2012年7月至2015年10月在湖北省肿瘤医院收治的175例晚期NSCLC患者，分为两组：对照组（85例接受传统化疗的患者）和实验组（90例接受吉非替尼联合化疗的患者）。采用酶联免疫吸附测定（ELISA）检测血清中EGFR和CYFRA21-1的表达水平。比较两组的治疗效果和3年生存率，并分析影响患者生存的因素。实验组的总有效率和局部有效率均显著高于对照组（P<0.05）。治疗前，两组EGFR和CYFRA21-1水平差异无统计学意义（P>0.05）。治疗后，两组EGFR和CYFRA21-1的表达水平均显著低于治疗前（P<0.05）。根据3年生存率，将实验组分为生存组和非生存组。对一般资料进行单因素分析，结果显示影响生存的因素包括KPS评分、吸烟史、病灶数量、病理分期、EGFR和CYFRA21-1。吉非替尼可显著提高晚期NSCLC患者的治疗效果，降低EGFR和CYFRA21-1的表达水平，并延长患者的生存时间。确诊吸烟史、KPS评分小于或等于60分、多发病灶、病理IV期、EGFR和CYFRA21-1高表达等指标是影响晚期NSCLC患者生存的重要因素。
