论文部分内容阅读
目的:探讨吉非替尼治疗不同基因表达的NSCLC患者的临床疗效,并观察治疗前后患者血清中EGFR、HER2以及癌胚抗原(CEA)、细胞角蛋白19片段(CYFRA 21-1)、神经特异性烯醇化酶(NSE)、促胃酸激素释放肽前体(pro-GRP)的表达情况。方法:将患者分为4组,A组为EGFR基因和HER2基因同时突变,B组为EGFR基因突变,C组为HER2基因突变,D组为无EGFR基因和HER2基因突变。应用吉非替尼分别治疗上述患者,同时检测EGFR、HER2以及CEA、CYFRA21-1及NSE、PROGRP在治疗前后血清中的含量。同时用生物素原过氧化物酶法(S-P法)检测EGFR和HER2在治疗前后组织中的表达量。结果:A组、B组和C组患者血清和组织中EGFR和HER2浓度在治疗后均有不同程度的下降(P<0.05),D组患者治疗后血清和组织中EGFR和HER2浓度无明显变化(P>0.05)。A组患者治疗后血清和组织中EGFR和HER2浓度下降较其他三组明显,这和患者在治疗后的临床表现相一致,表现为咳嗽减轻、疼痛减轻、病灶减小。A组、B组和C组患者血清中CEA、CYFRA21-1及NSE、PROGRP浓度在治疗后均有不同程度的下降(P<0.05),D组患者治疗后血清中CEA、CYFRA21-1及NSE、PROGRP浓度无明显变化(P>0.05)。结论 :应用吉非替尼对于有EGFR和HER2基因同时突变的患者,效果要优于单个基因突变的患者。
Objective: To investigate the clinical efficacy of gefitinib in the treatment of NSCLC patients with different gene expression, and to observe the serum EGFR, HER2 and CEA, CYFRA21-1 before and after treatment, neuroendocrine Enolase (NSE), properolein-releasing peptide precursor (pro-GRP) expression. Methods: The patients were divided into 4 groups: group A was EGFR gene and HER2 gene mutation at the same time; group B was EGFR gene mutation; group C was HER2 gene mutation; group D was EGFR gene and HER2 gene mutation. The above patients were treated with gefitinib. Meanwhile, the levels of EGFR, HER2, CEA, CYFRA21-1 and NSE were detected in serum before and after treatment. At the same time, the expression of EGFR and HER2 in the tissues before and after treatment was detected by biotin peroxidase method (S-P method). Results: The concentrations of EGFR and HER2 in serum and tissues of group A, group B and group C decreased to some extent after treatment (P <0.05), and the concentrations of EGFR and HER2 in serum and tissue of group D did not change significantly (P> 0.05). The decrease of EGFR and HER2 in serum and tissue in group A was more obvious than the other three groups after treatment, which was consistent with the clinical manifestations of patients after treatment. The symptoms were cough relief, pain relief and lesion reduction. Serum levels of CEA, CYFRA21-1, NSE and PROGRP in group A, group B and group C decreased to some extent after treatment (P <0.05), serum CEA, CYFRA21-1 and NSE in group D , PROGRP concentration had no significant change (P> 0.05). CONCLUSIONS: Gefitinib is superior to patients with single gene mutations in patients with simultaneous EGFR and HER2 mutations.