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目的探讨分子靶向药物治疗非小细胞肺癌(NSCLC)过程中肿瘤缩小而癌胚抗原升高的临床意义。方法 42例患者分为观察组(肺部瘤体缩小而癌胚抗原升高组)20例和对照组(肺部瘤体缩小而癌胚抗原下降组)22例。均予口服厄洛替尼片150 mg,1次/d,或者口服吉非替尼250 mg1,次/d;直到疾病进展、死亡或发生不可耐受的不良反应。观察疗效、不良反应及评价生活质量。结果观察组有效率20.0%,低于对照组50.0%,两组比较有统计学差异(P<0.05)。观察组Karnofsky计分提高+稳定者45.0%(9/20)、对照组77.3%(17/22),观察组生活质量改善低于对照组(P<0.05);观察组不良反应发生率与对照组比较,差异无统计学意义(P>0.05)。两组2年生存率比较有统计学差异(P<0.05)。结论 NSCLC经分子靶向药物治疗后肺部瘤体缩小而癌胚抗原升高提示预后不佳,存在身体其他部位病灶未控制的可能。
Objective To investigate the clinical significance of molecular targeted drug therapy for the treatment of non-small cell lung cancer (NSCLC) with tumor shrinkage and elevated carcinoembryonic antigen. Methods Twenty-two patients were divided into observation group (lung tumor shrinkage and carcinoembryonic antigen elevation group) and control group (lung tumor shrinkage and carcinoembryonic antigen reduction group). Erlotinib tablets were given orally 150 mg once daily or gefitinib 250 mg once daily until the disease progressed and died or an intolerable adverse reaction occurred. Observation of efficacy, adverse reactions and evaluation of quality of life. Results The effective rate of the observation group was 20.0%, which was lower than that of the control group (50.0%). There was significant difference between the two groups (P <0.05). The Karnofsky score increased 45.0% (9/20) in the observation group and 77.3% (17/22) in the control group, and the improvement in quality of life in the observation group was lower than that in the control group (P <0.05). The incidence of adverse reactions in the observation group was significantly lower than that in the control group There was no significant difference between the two groups (P> 0.05). The 2-year survival rates of the two groups were statistically different (P <0.05). Conclusion The shrinkage of lung neoplasms and the rise of carcinoembryonic antigen after NSCLC treatment with molecular targeted drugs suggest that the prognosis is poor, and the lesions in other parts of the body may not be controlled.