奥希替尼靶向治疗对晚期非小细胞肺癌患者免疫功能及肿瘤细胞因子的影响

Impact of targeted therapy with osimertinib on immune function and tumor cytokines in patients with advanced non-small cell lung cancer

摘要:

目的 探究奥希替尼靶向治疗对晚期非小细胞肺癌（NSCLC）患者免疫功能及肿瘤细胞因子的影响。方法 回顾性分析2022年1月至2023年12月江西省胸科医院收治的98例晚期NSCLC患者的临床资料，按治疗方法不同分为两组，各49例。对照组给予常规化疗，观察组给予奥希替尼靶向治疗。比较两组临床疗效、生存质量、免疫功能、肿瘤细胞因子及不良反应。结果 观察组疾病控制率（91.84%）高于对照组（73.47%）；治疗后，观察组Karnofsky体能状态评分（80.67±7.45）分高于对照组（74.67±7.67）分，T淋巴细胞亚群CD3⁺（68.92±7.82）%、CD4⁺（36.52±8.75）%及CD4⁺/CD8⁺（1.85±0.53）高于对照组的（59.72±6.44）%、（30.26±6.65）%、（1.24±0.32），CD8⁺（19.82±2.37）%低于对照组（24.81±1.95）%，癌胚抗原（13.04±2.86）ng/mL、鳞状上皮细胞癌抗原（1.75±0.52）ng/mL、神经元特异性烯醇化酶（15.26±2.41）ng/mL、细胞角蛋白19片段抗原21-1（3.05±1.12）ng/mL、血管内皮生长因子（373.56±45.25）ng/L、基质金属蛋白酶9（110.23±12.57）mg/L均低于对照组的（22.11±9.18）ng/mL、（2.25±0.97）ng/mL、（20.05±3.15）ng/mL、（3.54±1.03）ng/mL、（428.13±56.72）ng/L及（126.46±13.88）mg/L，且不良反应发生率（10.20%）低于对照组（28.57%），均有统计学差异（P＜0.05）。结论 奥希替尼靶向治疗对晚期NSCLC患者疗效显著，可有效控制疾病发展，改善机体免疫功能，降低机体肿瘤细胞因子水平，提升生存质量，且较为安全。

Abstract:

Objective To explore the effects of targeted treatment with osimertinib on immune function and tumor cytokines in patients with advanced non-small cell lung cancer (NSCLC).Methods A retrospective analysis was conducted on 98 patients with advanced NSCLC admitted to Jiangxi Provincial Chest Hospital from January 2022 to December 2023. These patients were divided into two groups based on different treatment methods, with 49 patients in each group. The control group received conventional chemotherapy, while the observation group received targeted therapy with osimertinib. The clinical efficacy, quality of life, immune function, tumor cytokines, and adverse reactions were compared between the two groups. Results The disease control rate in the observation group (91.84%) was higher than that in the control group (73.47%); After treatment, the Karnofsky performance status score of the observation group (80.67±7.45) was higher than that of the control group (74.67±7.67). The levels of T lymphocyte subsets CD3⁺ (68.92±7.82)%, CD4⁺ (36.52±8.75)%, and CD4⁺/CD8⁺ (1.85±0.53) were higher than those of the control group (59.72±6.44)%, (30.26±6.65)%, and (1.24±0.32), respectively. The level of CD8⁺ (19.82±2.37)% was lower than that of the control group (24.81±1.95)%. The levels of carcinoembryonic antigen (13.04±2.86) ng/mL, squamous cell carcinoma antigen (1.75±0.52) ng/mL, neuron-specific enolase (15.26±2.41) ng/mL, cytokeratin 19 fragment antigen 21-1 (3.05±1.12) ng/mL, vascular endothelial growth factor (373.56±45.25) ng/L, and matrix metalloproteinase 9 (110.23±12.57) mg/L were lower than those of the control group [(22.11±9.18) ng/mL, (2.25±0.97) ng/mL, (20.05±3.15) ng/mL, (3.54±1.03) ng/mL, (428.13±56.72) ng/L, and (126.46±13.88) mg/L], respectively. Additionally, the incidence of adverse reactions (10.20%) was lower than that of the control group (28.57%), showing statistical differences (P＜0.05).Conclusion Osimertinib targeted therapy has significant efficacy in patients with advanced NSCLC, effectively controlling disease progression, improving immune function, reducing tumor cytokine levels, and improving quality of life, while being relatively safe.