内科

目的探讨吉非替尼联合顺铂治疗晚期非小细胞肺癌的疗效及EGFR基因突变对疗效的影响。方法选择晚期非小细胞肺癌患者52例为研究对象，采用随机数字表法分为对照组与研究组，每组26例。对照组患者使用顺铂治疗，研究组患者联合使用顺铂和吉非替尼治疗。检测比较两组患者治疗前、治疗3个疗程后的癌胚抗原（CEA）以及乳酸脱氢酶（LDH）水平、临床疗效及治疗期间出现的不良反应；检测观察组患者的EGFR基因突变情况，分析基因突变对疗效的影响。结果治疗3个疗程，观察组患者的近期疗效显著优于对照组（P＜0.05），LDH水平显著低于对照组（P＜0.01）。治疗期间，观察组患者皮疹、腹泻发生率明显高于对照组（P＜0.01）。在接受吉非替尼治疗的26例观察组患者中，9例存在EGFR基因TK区突变，出现突变患者的疗效优于无突变患者（P＜0.05）。结论顺铂和吉非替尼的联合用药对非小细胞肺癌疗效显著，出现EGFR基因突变的患者能获得更好的疗效。

ObjectiveTo investigate the efficacy of gefitinib combined with cisplatin in the treatment of advanced non-small-cell lung cancer and the effect of EGFR gene mutation on the curative effect. Methods52 patients with advanced non-small-cell lung cancer were selected. They were randomly divided into control group and research group, 26 cases in each group. The control group were treated with cisplatin, while the study group were treated with cisplatin and gefitinib. Detection of carcinoembryonic antigen (CEA) and lactate dehydrogenase (LDH) levels, clinical efficacy and adverse reactions of two groups of patients before and after 3 courses of treatment were compared. The mutation of EGFR gene in the observation group was detected, and the effect of gene mutation on the curative effect was analyzed. ResultsAfter 3 courses of treatment, the short-term curative effect of the observation group was significantly better than that of the control group (P＜0.05), and the level of LDH was significantly lower than that of the control group (P＜0.01). The incidence of rash and diarrhea in the observation group was significantly higher than that in the control group during the treatment period (P＜0.01). 26 patients received gefitinib treatment in the observation group, of which 9 cases had the EGFR gene TK region mutation, and the effect of the mutation was better than that of the non mutagenesis patients (P＜0.05). ConclusionThe combination of cisplatin and gefitinib has a significant effect on non-small-cell lung cancer, and patients with EGFR mutation can achieve better results.