曲妥珠单抗联合TC化疗对HER-2阳性晚期乳腺癌外周血及预后影响  

Effect of trastuzumab combined with TC chemotherapy on peripheral blood and prognosis of HER-2 positive advanced breast cancer

作　　者：赵敏 戴成燕 丁平 闫睿 Zhao Min;Dai Chengyan;Ding Ping;Yan Rui(Department of Medical Oncology,Second Hospital of Chaoyang City,Liaoning Chaoyang 122000,China)

机构地区：[1]朝阳市第二医院肿瘤内科,辽宁朝阳122000

出　　处：《现代肿瘤医学》2020年第14期2431-2435,共5页Journal of Modern Oncology

摘　　要：目的:探究曲妥珠单抗联合TC(环磷酰胺+多西他赛)化疗对人类表皮生长因子受体-2(HER-2)阳性晚期乳腺癌患者外周血T淋巴细胞亚群、组织多肽特异性抗原(TPS)水平及预后的影响。方法:选取2015年1月-2017年3月我院72例HER-2阳性晚期乳腺癌作为研究对象,依据随机数字表法分组,各36例。对照组于乳腺癌改良根治术前予以TC化疗,观察组于对照组基础上予以曲妥珠单抗治疗。统计两组客观缓解率、无进展生存期及治疗前后血清T淋巴亚群、糖链抗原125(CA125)、TPS水平及生存质量(KPS)评分。采用方差、卡方进行统计学分析。结果:观察组客观缓解率44.44%较对照组22.22%高,差异有统计学意义(P=0.046);观察组治疗后血清CD3+、CD4+、CD8+、CD4+/CD8+与对照组相比,差异无统计学意义(P>0.05);观察组治疗后血清CA125水平[(32.10±3.46)IU/ml]、TPS水平[(263.41±53.84)IU/ml]低于对照组[(38.59±2.39)IU/ml,(355.26±47.84)IU/ml],差异具有统计学意义(P均<0.001);观察组治疗后KPS评分[(91.06±3.85)分]高于对照组[(85.49±5.32)分],差异具有统计学意义(P<0.001);观察组无进展生存期为(19.22±1.37)个月较对照组(15.43±1.35)个月长,差异有统计学意义(P=0.000)。结论:对HER-2阳性晚期乳腺癌患者予以TC化疗同时,加用曲妥珠单抗,可明显提高化疗效果,有效降低患者血清CA125、TPS水平,延长无进展生存期,提高生存质量,且未增加免疫功能损伤,值得临床推广与应用。Objective:To investigate the peripheral blood T lymphocyte subsets of human epidermal growth factor receptor-2(HER-2)-positive advanced breast cancer patients treated with trastuzumab combined with TC(cyclophosphamide+docetaxel)chemotherapy on the effect of tissue polypeptide-specific antigen(TPS)levels and prognosis.Methods:72 cases of HER-2 positive advanced breast cancer were selected from January 2015 to March 2017 as the research subjects,and 36 cases were grouped according to the random number table method.The control group received TC chemotherapy before modified radical mastectomy,and the observation group received trastuzumab on the basis of the control group.The objective response rate,progression-free survival and serum T lymphocyte subsets,glycoprotein antigen 125(CA125),TPS levels and quality of life(KPS)scores were compared before and after treatment.Statistical analysis was performed using variance and chi-square.Results:The objective response rate of the observation group was 44.44%higher than that of the control group(22.22%),and the difference was statistically significant(P=0.046).There was no significant difference in serum CD3+,CD4+,CD8+,CD4+/CD8+between the observation group and the control group(P>0.05).The serum CA125 level in the observation group after treatment[(32.10±3.46)IU/ml],The TPS level[(263.41±53.84)IU/ml]were lower than that of the control group[(38.59±2.39)IU/ml,(355.26±47.84)IU/ml],and the difference was statistically significant(P<0.001),KPS score[(91.06±3.85)points]was higher in the observation group than in the control group[(85.49±5.32)points],and the difference was statistically significant(P<0.001).PFS in the observation group was(19.22±1.37)months compared with the control group(15.43±1.35)months,and the difference was statistically significant(P=0.000).Conclusion:TC chemotherapy for patients with HER-2 positive advanced breast cancer,combined with trastuzumab,can significantly improve the effect of chemotherapy,effectively reduce serum CA125,TPS levels,prolong

关 键 词：HER-2阳性晚期乳腺癌 TC化疗 曲妥珠单抗 T淋巴细胞亚群 TPS水平 预后 

分 类 号：R737.9[医药卫生—肿瘤]