外周血E_2水平与三苯氧胺治疗ER^+乳腺癌疗效关系的临床研究  

Clinical study of relationship between peripheral blood E_2 level and Tamoxifen for ER^+ breast cancer

作　　者：张宾[1] 陈志军[1] 孙正魁[1] 杨丽萍[1] 

机构地区：[1]江西省肿瘤医院,南昌330029

出　　处：《江西医药》2013年第10期866-868,共3页Jiangxi Medical Journal

摘　　要：目的探讨外周血雌激素(E2)水平与三苯氧胺治疗ER+乳腺癌疗效关系。方法对我院收治的50例经病理证实的手术后ER+乳腺癌患者进行内分泌治疗(A组),其中绝经前患者(A1组)28例,绝经后患者(A2组)22例;同时设立对照组:良性乳腺疾病(B组)和健康体检(C组)各50例。治疗前、后进行血清E2检测。结果治疗前,A组血清E2水平明显低于B组、C组(P<0.05)。A组三苯氧胺治疗前血清E2水平低于治疗后(P<0.05);B组手术前血清E2与术后血清E2无显著性差异(P>0.05)。三苯氧胺治疗后,A组患者血清E2水平升高的7例中,其中A1组6例(占21.43%),A2组1例(4.54%),A1组血清E2水平升高的例数及水平6例显著高于A2组(P<0.05)。A组三苯氧胺治疗后总有效率70.0%(35/50)。血清E2升高与血清E2正常的患者近期有效率(CR+PR)分别为28.57%(2/7例)、76.74%(33/43例),两组比较Hc=3.021,差异有显著性(P<0.05)。血清E2升高7例患者中,以浸润性导管癌乳腺癌居多,且TNM分期晚,内分泌治疗效果较差(P<0.05)。结论三苯氧胺抑制后雌激素水平低的患者,治疗疗效好,相反在三苯氧胺治疗过程中,雌激素水平一直高居不下或者在治疗过程中出现雌激素水平最高者,往往治疗失败。Objective To explore the relationship between peripheral blood level of estrogen（E2） and Tamoxifen for ER＋breast cancer. Methods 50 patients pathologically confirmed after surgery as ER＋breast cancer were received endocrine therapy （as A group）. including Premenopausal patients（A1）28 cases,22 cases of postmenopausal patients （A2）;and there were 2 control groups. Serum E2 was detected before treatment. Results Before treatment,serum E2 level in group A was significantly lower than in group B and group C （P〈0.05）. Serum E2 levels before Tamoxifen treatment was lower than（P〈0.05） after treatment in group A;Serum E2 in group B before and after surgery had no significant difference （P〉0.05）. After Tamoxifen treatment,7 cases of group A patients increased serum E2 levels, 6 cases in A1 group （21.43%）,1 patient in A2 Group （4.54%）,6 cases of E2 level in A1 was signifi-cantly higher than A2 （P〈0.05）. In group A,the total effective rate was 70.0%（35/50）. Recent response rate （CR＋PR） were 28.57%（2/7） and 76.74% （33/43 cases） in patients with elevated serum E2 and normal serum E2. Hc=3.021 and the difference was signifi-cant（P〈0.05）. 7 cases of elevated serum E2,the majority was invasive ductal carcinoma,and TNM stage was late and endocrine therapy was less effective（P〈0.05）. Conclusion Breast cancer patients with low estrogen levels after treatment are more effective, and patients with higher estrogen levels often fails the treatment.

关 键 词：乳腺癌 ER阳性 雌激素水平 三苯氧胺治疗 

分 类 号：R737.9[医药卫生—肿瘤]