关键词:  , 非小细胞肺癌, 晚期, 表皮生长因子受体阳性, 吉非替尼, 分泌型蛋白Dikkopf-1, 前梯度蛋白2, 疗效, 安全性, 预后

Abstract:

Objective　To study the efficacy and safety of gefitinib in the treatment of advanced non-small cell lung cancer (NSCLC) patients with positive epidermal growth factor receptor (EGFR). Methods　A prospective study was conducted on 102 patients with EGFR-positive NSCLC who were treated in No.215 Hospital of Shaanxi Nuclear Industry from March 2019 to February 2021, and they were divided into a control group (51 cases) and a study group (51 cases) according to the random number table method. In the control group, there were 30 males and 21 females, aged (57.38±5.19) years, 20 cases in stage ⅢB and 31 cases in stage Ⅳ, 11 cases of squamous cell carcinoma and 40 cases of adenocarcinoma. In the study group, there were 28 males and 23 females, aged (56.99±5.32) years, 25 cases in stage ⅢB and 26 cases in stage Ⅳ, 8 cases of squamous cell carcinoma and 43 cases of adenocarcinoma. The control group received docetaxel treatment, intravenous infusion with 75 mg/m² of docetaxel, 3 weeks as a cycle, and the treatment lasted for at least 2 cycles. The study group received gefitinib orally, 250 mg each time, once a day, until the disease progressed or the patient could not tolerate it and the drug was discontinued. The χ² test was used to compare the clinical efficacies and adverse reactions of the two groups. The t-test was used to compare the changes of EGFR, secretory protein Dikkopf-1 (DKK1), pre-gradient protein 2 (AGR2), and tumor markers [squamous cell carcinoma antigen (SCC), non-small cell lung cancer antigen 21-1 (CYFRA21-1), and carcinoembryonic antigen (CEA)] before treatment and one month after treatment in the two groups. The Log-rank test was used to compare the 3-year survival rates of the two groups. Results　The disease control rate of the study group was 82.35% (42/51), which was higher than 54.90% (28/51) of the control group, with a statistically significant difference (P<0.05). One month after treatment, the levels of EGFR, DKK1, and AGR2 in both groups decreased; the levels of EGFR, DKK1, and AGR2 in the study group were (37.94±4.22) μg/L, (3.59±0.85) μg/L, and (8.04±1.68) ng/L, which were lower than those in the control group [(50.11±5.83) μg/L, (5.04±1.02) μg/L, and (12.45±2.59) ng/L], with statistically significant differences (all P<0.05). One month after treatment, the levels of SCC, CYFRA21-1, and CEA in both groups decreased; the levels of SCC, CYFRA21-1, and CEA in the study group were (1.23±0.27) μg/L, (7.76±1.03) μg/L, and (46.19±5.83) μg/L, which were lower than those in the control group [(1.76±0.28) μg/L, (10.24±1.25) μg/L, and (53.17±6.84) μg/L], with statistically significant differences (all P<0.05). The total incidence of adverse reactions in the study group was 21.57% (11/51), which was lower than 41.18% (21/51) in the control group, with a statistically significant difference (P<0.05). The overall survival period of the study group was (29.71±3.61) months, which was longer than that of the control group [(23.21±3.28) months], with a statistically significant difference (P<0.05). Conclusion　Gefitinib can improve the curative effect of EGFR-positive advanced NSCLC patients, down-regulate the expressions of EGFR, DKK1, and AGR2, reduce the levels of tumor markers, has high safety, and is beneficial to the improvement of prognosis.

Key words: Non-small cell lung cancer,  , Advanced,  , Epidermal growth factor receptor positive,  , Gefitinib,  , Secretory protein Dikkopf-1,  , Pre-gradient protein 2,  , Therapeutic effect,  , Security,  , Prognosis