诺雷德联合他莫昔芬对早期乳腺癌血清雌激素、胰岛素样生长因子、E-钙黏蛋白水平及预后的影响  

The effects of zoladex combined with tamoxifen endocrine therapy on expression ofβ-eatradiol,insulin-like growth factor 1,E-cadherin and prognosis in early breast cancer patients

作　　者：张丹丹 徐旭东 罗智勇 夏耘 吴亚群[3] 黄自明[2] Zhang Dandan;Xu Xudong;Luo Zhiyong;Xia Yun;Wu Yaqun;Huang Ziming(Medical College,Wuhan University of Science and Technology,Wuhan 430065,China;Department of Thyroid and Breast Surgery,Maternal and Child Health Hospital of Hubei Province,Wuhan 430070,China;Department of Thyroid and Breast Surgery,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030,China)

机构地区：[1]武汉科技大学医学院,430081 [2]湖北省妇幼保健院甲乳外科,武汉430070 [3]华中科技大学同济医学院附属同济医院甲乳外科,武汉430030

出　　处：《中华实验外科杂志》2021年第11期2229-2231,共3页Chinese Journal of Experimental Surgery

基　　金：湖北省自然科学基金(2018CFC838)。

摘　　要：目的探讨诺雷德联合他莫昔芬内分泌治疗对早期乳腺癌雌激素(E2)、胰岛素样生长因子1(IGF-1)、E-钙黏蛋白(E-cadherin)表达及预后的影响。方法 2010年2月至2016年1月我院和华中科技大学同济医学院附属同济医院收治的285例Ⅰ~Ⅲ期HR+乳腺癌患者按均衡随机化方法分为对照组和研究组,除常规手术和化疗外,对照组140例给予他莫昔芬(TAM) 5年内分泌治疗,研究组145例给予卵巢功能抑制(OFS)+TAM 5年联合内分泌治疗,分别于术前、内分泌治疗2年后、内分泌治疗5年后检测血清雌二醇、IGF-1、E-cadherin水平,同时观察两组患者5年无病生存率和总生存率,并采用χ^(2)检验、Spearman相关性分析法进行统计分析。结果两组乳腺癌患者术前血清E2、IGF-1、E-钙黏蛋白水平比较差异均无统计学意义(P>0.05)。内分泌治疗2年后,研究组患者血清E2水平[(77.16±7.44) pg/ml]明显低于对照组[(94.13±9.26) pg/ml,P<0.05];研究组患者血清IGF-1水平[(59.90±6.24) ng/ml]明显低于对照组[(83.62±8.15) ng/ml,P<0.05];研究组患者血清E-钙黏蛋白水平[(6.11±0.73) mg/ml]明显高于对照组[(4.78±0.55) mg/ml,P<0.05]。内分泌治疗5年后两组患者E2、IGF-1、E-cadherin水平差异均有统计学意义(P<0.01)。对照组5年无病生存率(DFS)为94.3%;研究组5年DFS为94.5%;两组之间差异无统计学意义(P>0.05)。对照组5年总生存期(OS)为100%,研究组患者5年OS为100%,两组之间差异无统计学意义(P>0.05)。结论诺雷德联合他莫昔芬内分泌治疗可以显著降低早期乳腺癌E2、IGF-1水平,并提高E-cadherin,有利于降低肿瘤复发风险。Objective To investigate the effects of zoladex combined with tamoxifen endocrine therapy on expression of E2,IGF-1,E-cadherin and prognosis in early breast cancer patients.Methods 227 cases ofⅠ-Ⅲstage early breast cancer patients entered the study.They were randomly divided into control group and research group.Only tamoxifen endocrine therapy was affected in control group,while zoladex combined with tamoxifen endocrine therapy was applied in research group.The changes of E2,insulin-like growth factor 1(IGF-1),E-cadherin level were detected in the patients respectively at time point pre-operation,2 years after endocrine therapy and 5 years after endocrine therapy.The five-year disease-free survival rate and overall survival rate were also observed in two groups.Chi-square test and Spearman correlation analysis were applied in statistical research.Results Compared with control group,the changes of of E2,IGF-1,E-cadherin level had no significant differences in research group before operation(P>0.05).At 2 years after endocrine therapy,the level of E2[(94.13±9.26)pg/ml]in control group was significantly higher than that(77.16±7.44)pg/ml in research group(P<0.05).And the level of IGF-1[(83.62±8.15)ng/ml]in control group was significantly higher than that(59.90±6.24)ng/ml in research group(P<0.05).However,the level of E-cadherin[(4.78±0.55)mg/ml]in control group was markedly lower than that(6.11±0.73)mg/ml in research group(P<0.05).Furthermore,there were obvious differences at 5 years after endocrine therapy for three indicators between two groups(P<0.01).The five-year disease-free survival rate is 98.0%in control group,however the five-year disease-free survival rate is 97.6%in research group,there were no significant differences between two groups(P>0.05).And there were no significant differences for five-year overall survival rate between two groups(P>0.05).Conclusion Zoladex combined with tamoxifen endocrine therapy not only reduces E2,IGF-1 level but also enhances E-cadherin level in early breast cancer

关 键 词：诺雷德 他莫昔芬 早期乳腺癌 早期乳腺癌雌激素 胰岛素样生长因子1 E-钙黏蛋白 

分 类 号：R737.9[医药卫生—肿瘤]