Objective To study the efficacy and toxicity related gene polymorphism in non-small cell lung cancer patients with gemcitabine chemotherapy.Methods 40 patients with non-smallcell lung cancer were chosen in the present study.The leukocyte DNA was extracted from blood samples.ERCC1 118 genotypes were detected by PCR-RFLP.The relationship between ERCC1 118 genotype and the chemotherapy efficacy and toxicity of patients received gemcitabine was analyzed.Results The age,gender,pathological type,clinical stage,and other factors had no relation with the treatment effects (P ＞ 0.05).The frequency of C/C genotype was 55.0％ (22/40),the frequency of C/T +T/T genotype was 45.0％ (18/40).The effective rate was 45.5％ in patients carrying the C/C gene,The effective rate was 22.2％ in patients carrying the C/T + T/T gene,the difference between the two groups was not statistically significant (x2 =2.3488,P ＞ 0.05).Conclusion The ERCC1 gene polymorphism is not significantly correlated with the efficacy and toxicity of gemcitabine chemotherapy.

Objective To study the level of serum vascular endothelial growth factor(sVEGF)in advanced non-small cell lung cancer(NSCLC) and its clinical significance.Methods Serum level of VEGF was detected by ELISA method in 96 patients with advanced NSCLC.sVEGF level was analyzed after giving 2-4 cycles of cisplatin-based chemotherapy.At the same time,serum level of VEGF in 50 healthy controls was detected.Results The level of sVEGF was significantly higher in patient with lung cancer than in control group (P＜0.01).No statistical significant defference was observed between sVEGF level of stage Ⅲ and Ⅳ NSCLC patients,the patients with squamocellular lung cancer and adenocarcinoma(P＞0.05);Descended sVEGF level was found in the patients with response to chemotherapy(P＜0.05).Conclusion sVEGF can be used to evaluate chemotherapy response and diagnoses in the patients with advanced NSCLC.

Objective To study the relationship between expression of matrix metalloproteinases-7 (MMP-7) and clinicopathological characteristics in patients with primary non-smaU cell lung cancer(NSCLC). Methods MMP-7 in 20 normal people and 60 advanced NSCLC patiens were detected with reverse-transcription-polymerase-chain-reaction. Gelatum image analysator analyzed the result. Results The amount of MMP-7 was less in normal people (30.000) than in NSCLC patients(41.231) significantly(P<0.05); the level of MMP-7 was no correlated with gender, age, pathology pattern, tumor size, was inverse correlation with differentiation, and was positive correlation with clinical stages(P <0.05). Conclusion The level of MMP-7 is closely correlated with tissue differentiation and clinical stages of NSCLC, which may serve as a parameter for determining tumor invasion and metastatic.

Objective To investigate the relationships of neuron-specific enolase (NSE) and progastrin-releasing peptide (ProGRP) with the initial chemotherapeutic effect and survival of patients with small-cell lung cancer (SCLC).Methods A total of 197 patients with SCLC diagnosed pathologically from January 2011 to September 2013 in Shanxi Provincial Cancer Hospital were selected.x 2 test and logistic regression analysis were used to analyze the factors affecting the initial chemotherapeutic response;KaplanMeier method,log-rank test and Cox regression analysis were used to analyze the factors affecting survival of patients.Results Among the 197 patients,NSE was negative in 64 cases and positive in 133 cases;ProGRP was negative in 51 cases and positive in 146 cases;41 cases with hyponatremia and 156 cases without hyponatremia.152 cases (77.2 ％) had well response to initial treatment and 45 cases (22.8 ％) had no reaction.Univariate analysis showed that stage of disease (x2 =4.456,P =0.033) and ProGRP (x2 =13.424,P ＜ 0.001) were associated with initial therapeutic response.Logistic regression analysis showed that stage of disease (OR =0.404,95 ％ CI 0.197-0.828％,P =0.013) and ProGRP (OR =4.058,95 ％ CI 1.939-8.491,P =0.000) were the independent predictors of initial therapeutic response.Kaplan-Meier survival analysis showed that sex,age,smoking,with or without hyponatremia,stage of disease,NSE,ProGRP and number of chemotherapy cycles were all associated with 2-year survival rate (x2 values were 4.319,6.811,4.264,4.687,32.631,41.045,11.379,33.466,respectively,all P ＜ 0.05).Multivariate analysis showed that stage of disease (RR =2.110,95 ％ CI 1.491-2.985,P ＜ 0.001),number of chemotherapy cycles (RR =0.398,95 ％ CI 0.283-0.588,P ＜ 0.001) and NSE (RR =1.422,95 ％ CI 1.113-1.784,P =0.002) were independent predictors of survival.However,ProGRP was not associated with survival of patients (RR =1.065,95 ％ CI 0.854-1.328,P =0.587).Conclusions ProGRP is associated with the initial chemotherapeutic response in patients with SCLC,and it has certain clinical significance in predicting the initial chemotherapeutic effect.NSE is associated with the survival prognosis of SCLC,and it is a prognostic factor of poor survival.

BACKGROUNDTo evaluate the efficacy and toxicity of ifosfamide and cisplatin in the treatment of advanced non-small cell lung cancer.

METHODSFifty-six patients with advanced non-small cell lung cancer were treated by combination chemotherapy of ifosfamide and cisplatin for two cycles: ifosfamide 1.5-2.0g/m² iv drip on day 1-4, mesna 400mg iv at 0,4,8 hours after using ifosfamide; DDP 25-30mg/m² iv drip on day 5-7. The response, toxicity, relievable period and survival period were evaluated.

RESULTSThe total response rate was 50.0%. The response rate of patients in primary treatment was 52.8% and that of return cases was 45.0% (P > 0.05). The median relievable period was five months. The median duration of survival (MDS) was nine months. The major toxicity was inhibition of bone marrow, especially of leukocyte and platelet.

CONCLUSIONSCombination chemotherapy of ifosfamide and cisplatin is effective in the treatment of advanced non-small cell lung cancer including the return cases, and the toxicity is tolerable. If G-CSF is used as a complementary therapy, this regimen could be quite clinically valuable.

Objective:To investigate the therapeutic effect difference between first-line treatment with epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKI) and chemotherapy in non-small cell lung cancer (NSCLC) patients with epidermal growth factor receptor (EGFR) rare mutation.Methods:A retrospective case-control study was performed. Data of NSCLC patients with rare EGFR mutation who were treated in Shanxi Province Cancer Hospital from January 2013 to October 2019 were retrospectively analyzed. EGFR mutations in living tissues or blood were detected by using amplification refractory mutation system-polymerase chain reaction (ARMS-PCR) before first-line treatment. According to first-line treatment methods,they were divided into EGFR-TKI treatment group and chemotherapy group. Objective remission rate (ORR) and disease control rate (DCR) of both groups were compared. Kaplan-Meier method was used to draw progression-free survival (PFS) and the overall survival (OS) curves. Log-rank test was used for comparison among groups. Single-factor and multi-factor Cox proportional risk models were used to analyze the influencing factors of PFS and OS.Results:A total of 169 patients with EGFR rare mutations were included, and the age [ M (IQR)] was 63 years (12 years); there were 96 cases (56.8%) < 65 years and 73 cases (43.2%) ≥65 years; 70 (41.4%)males and 99 (58.6%) females; 55 cases (32.5%) had EGFR G719X mutation,45 cases (26.6%) had L861Q mutation, 17 cases (10.1%) had S768I mutation, and 52 cases (30.8%) had complex mutation; 55 cases (32.5%) received the first-line chemotherapy and 114 cases (67.5%) received the first-line EGFR-TKI treatment. In the chemotherapy group, ORR was 36.4% (20/55) and DCR was 85.5% (47/55); in EGFR-TKI treatment group, ORR was 72.8% (83/114) and DCR was 90.4% (103/114). The ORR of EGFR-TKI treatment group was higher than that of chemotherapy group ( χ2 = 20.70, P = 0.001), and there was no statistically significant difference in DCR between two groups ( χ2 = 1.76, P = 0.184). Subgroup analysis showed that ORR in EGFR-TKI treatment group with G719X, L861Q and complex mutations was higher than that of the corresponding mutations in chemotherapy group, and the differences were statistically significant (all P < 0.05), while there were no significant differences in DCR among subgroups (all P > 0.05). The median PFS time was 9.7 months (95% CI: 6.0-13.4 months) and 3.8 months (95% CI: 3.1-7.1 months), respectively in EGFR-TKI treatment group and chemotherapy group, and there was a statistically significant difference in PFS between the two groups ( P < 0.001). The median OS time was 25.6 months (95% CI: 18.0-37.9 months) and 31.7 months (95% CI: 18.0-42.8 months), respectively in EGFR-TKI treatment group and chemotherapy group, and there was no statistically significant difference in OS between the two groups ( P = 0.231). Multivariate Cox regression analysis showed that brain metastasis [with vs. without: HR = 2.306, 95% CI: 1.452-3.661, P < 0.001] and the first-line treatment methods (EGFR-TKI vs. chemotherapy: HR = 0.457, 95% CI:0.317-0.658, P < 0.001) were independent influencing factors for PFS of NSCLC patients with EGFR rare mutation; brain metastasis (with vs. without: HR = 2.087, 95% CI: 1.102-3.953, P = 0.024; unknown vs. without: HR = 2.118,95% CI: 1.274-3.520, P = 0.004) were independent influencing factors for OS of NSCLC patients with EGFR rare mutation. Conclusions:Compared with the first-line chemotherapy, EGFR-TKI first-line treatment could improve objective remission and PFS of NSCLC patients with EGFR rare mutation, while no OS benefit is observed.