曲妥珠单抗联合术前新辅助化学治疗对乳腺癌患者肿瘤标志物、血管内皮因子和凋亡因子的影响及疗效观察  

Effect of trastuzumab combined with neoadjuvant chemotherapy on tumor markers,vascular endo thelial growth factor and apoptotic factors in patients with breast cancer and therapeutic effect analysis

作　　者：张婷[1] 刘起鹏[1] 郭婉莹 李鹏[1] 乔伟强 邓淼[1] ZHANG Ting;LIU Qipeng;GUO Wanying;LI Peng;QIAO Weiqiang;DENG Miao(Department of Breast Surgery,the First Affiliated Hospital of Henan University of Science and Technology,Luoyang 471003,Henan Province,China)

机构地区：[1]河南科技大学第一附属医院乳腺外科,河南洛阳471003

出　　处：《新乡医学院学报》2020年第11期1075-1079,共5页Journal of Xinxiang Medical University

摘　　要：目的探讨曲妥珠单抗联合术前新辅助化学治疗对乳腺癌患者肿瘤标志物、血管内皮因子和凋亡因子的影响及治疗效果。方法选择2015年1月至2018年7月河南科技大学第一附属医院收治的人表皮生长因子受体-2阳性乳腺癌患者80例为研究对象,依据治疗方式不同分为对照组和观察组,每组40例。对照组患者给予吡柔比星、环磷酰胺联合多西他赛方案进行术前新辅助化学治疗,21 d为1个周期,共6个周期;观察组患者在此基础上联合曲妥珠单抗治疗,21 d为1个周期,共4个周期。2组患者均于治疗前、后抽取空腹外周静脉血,采用酶联免疫吸附试验法检测血清癌胚抗原(CEA)、糖类抗原153(CA153)、血管内皮生长因子A(VEGFA)、血管内皮生长因子B(VEGFB)及血管内皮生长因子C(VEGFC)水平,采用Western blot检测诱骗受体3(DcR3)及环氧化酶-2(COX-2)蛋白表达水平;观察2组患者完全缓解(CR)、部分缓解(PR)、稳定(SD)、恶化(PD)以及化学治疗后的病理完全缓解(pCR)情况,比较2组患者缓解率(RR)和pCR率。结果治疗前,2组患者血清CEA、CA153、VEGFA、VEGFB、VEGFC水平及DcR3,COX-2蛋白表达水平比较差异均无统计学意义(P>0.05)。治疗后,2组患者血清CEA、CA153、VEGFA、VEGFB、VEGFC水平及DcR3,COX-2蛋白表达水平均显著低于治疗前(P<0.05)。治疗后,观察组患者血清CEA、CA153、VEGFA、VEGFB、VEGFC水平及DcR3,COX-2蛋白表达水平均显著低于对照组(P<0.05)。观察组患者RR和pCR率分别为75.00%(30/40)、45.00%(18/40),对照组患者RR和pCR率分别为45.00%(18/40)、20.00%(8/40),观察组患者RR和pCR率均显著高于对照组(P<0.05)。结论曲妥珠单抗联合新辅助化学治疗可有效降低乳腺癌患者血清肿瘤标志物、血管内皮因子及凋亡相关分子表达水平,提高近期疗效。Objective To investigate the effect of trastuzumab combined with neoadjuvant chemotherapy on tumor markers,vascular endothelial growth factor and apoptotic factors in patients with breast cancer and its therapeutic effect.Methods Eighty patients with human epidermalgrowth factor receptor-2 positive breast cancer admitted to the First Affiliated Hospital of Henan University of Science and Technology from January 2015 to July 2018 were selected as the research subjects.They were divided into the control group and the observation group according to different treatment methods,with 40 cases in each group.The patients in the control group were treated with pirirubicin,cyclophosphamide and docetaxel for neoadjuvant chemotherapy,and the patients were treated for six treatment cycles(21 days were a treatment cycle);the patients in the observation group were treated with trastuzumab on the basis of neoadjuvant chemotherapy consistent with the control group,and the patients were treated for treatment cycles(21 days were a treatment cycle).Fasting peripheral venous blood was drawn before and after treatment in both groups,the enzyme linked immunosorbent assay was used to detect the serum carcinoembryonic antigen(CEA),carbohydrate antigen 153(CA153),vascular endothelial growth factor A(VEGFA),vascular endothelial growth factor B(VEGFB),vascular endothelial growth factor C(VEGFC);and Western blot was used to detect the levels of decoy receptor 3(DcR3)and cyclooxygenase-2(COX-2)protein.The short-term effects of the two groups were observed,including complete remission(CR),partial mitigation(PR),stable disease(SD),progression disease(PD),the remission rate(RR)and complete pathological remission(pCR)rate were compared between the both groups.Results Before treatment,there was no significant difference in the levels of CEA,CA153,VEGFA,VEGFB,VEGFC and DcR3,COX-2 protein between the two groups(P>0.05).After treatment,the levels of CEA,CA153,VEGFA,VEGFB,VEGFC and DcR3,COX-2 protein in both groups were significantly lower than those

关 键 词：乳腺癌 曲妥珠单抗 新辅助化学治疗 肿瘤标志物 

分 类 号：R737.9[医药卫生—肿瘤]