吡柔比星、环磷酰胺联合白蛋白结合型紫杉醇新辅助化疗对三阴性乳腺癌患者Ki-67、MMP-9、VEGF及预后的影响  

Effect of Neoadjuvant Chemotherapy with Pirarubicin,Cyclophosphamide and Nab-Paclitaxel on Ki-67,MMP-9,Vascular Endothelial Growth Factor and Prognosis in Patients with Triple Negative Breast Cancer

作　　者：韩晓军[1] 苏梅[1] 杨巧 徐国强 甘继美 HAN Xiao-jun;SU Mei;YANG Qiao;XU Guo-qiang;GAN Ji-mei(Department of Thyroid and Breast Surgery,People's Hospital of Wenjiang District Wenjiang Hospital of People's Hospital of Sichuan Province,Chengdu 611130,China;Department of Pharmacy,People's Hospital of Wenjiang District Wenjiang Hospital of People's Hospital of Sichuan Province,Chengdu 611130,China)

机构地区：[1]成都市温江区人民医院四川省人民医院温江医院甲乳外科,成都611130 [2]成都市温江区人民医院四川省人民医院温江医院药学部,成都611130

出　　处：《临床误诊误治》2022年第9期58-62,共5页Clinical Misdiagnosis & Mistherapy

基　　金：2021年成都市医学科研课题(2021026)。

摘　　要：目的探讨吡柔比星、环磷酰胺联合白蛋白结合型紫杉醇新辅助化疗对三阴性乳腺癌患者细胞增殖核抗原(Ki-67)、基质金属蛋白酶-9(MMP-9)、血管内皮生长因子(VEGF)及预后的影响。方法选取2014年1月—2018年5月收治的三阴性乳腺癌72例,根据化疗方案不同将其分为观察组和对照组2组各36例。观察组采用吡柔比星、环磷酰胺联合白蛋白结合型紫杉醇新辅助化疗,对照组采用吡柔比星和环磷酰胺新辅助化疗。比较2组化疗前后Ki-67阳性情况、MMP-9相对表达量和VEGF水平,化疗过程中毒副反应及术后随访生存情况。结果化疗后,Ki-67阳性率、MMP-9相对表达量和VEGF-a、VEGF-b 2组均较治疗前降低,且观察组低于对照组(P<0.05,P<0.01)。化疗过程中,2组各毒副反应发生率比较差异无统计学意义(P>0.05)。术后2和3年,观察组总生存率高于对照组(P<0.05)。结论三阴性乳腺癌患者采用吡柔比星、环磷酰胺联合白蛋白结合型紫杉醇新辅助化疗可显著降低Ki-67阳性率、MMP-9相对表达量及VEGF水平,提高术后总生存率,且未增加化疗毒副反应。Objective To investigate the effects of neoadjuvant chemotherapy with Pirarubicin,Cyclophosphamide and Nano Albumin Binding-Paclitaxel(Nab-paclitaxel)on the proliferation cell nuclear antigen(Ki-67),matrix metalloproteinase-9(MMP-9),vascular endothelial growth factor(VEGF)and prognosis of triple negative breast cancer(TNBC)patients.Methods A total of 72 cases of TNBC admitted from January 2014 to May 2018 were selected and divided into the observation group(n=36)and the control group(n=36)according to different chemotherapy schemes.The observation group received neoadjuvant chemotherapy with Pirarubicin,Cyclophosphamide and Nab-paclitaxel,while the control group received neoadjuvant chemotherapy with Pirarubicin and Cyclophosphamide.Positive Ki-67,MMP-9 relative expression and VEGF level as well as toxic and side effects during chemotherapy and postoperative follow-up and survival were compared between the two groups before and after chemotherapy.Results After chemotherapy,the positive rate of Ki-67,the relative expression of MMP-9,and the levels of VEGF-a and VEGF-b in both groups were lower than those before treatment,which were lower in the observation group than in the control group(P<0.05,P<0.01).During chemotherapy,there was no significant difference in the incidence of toxic and side effects between the two groups(P>0.05).The total survival rate of the observation group was higher than that of the control group at 2 and 3 years after operation(P<0.05).Conclusion Neoadjuvant chemotherapy with Pirarubicin,Cyclophosphamide and Nab-paclitaxel in TNBC patients can significantly reduce the Ki-67 positive rate,the relative expression of MMP-9 and the level of VEGF,improve the overall postoperative survival rate of patients,and do not increase the toxic and side effects of chemotherapy.

关 键 词：乳腺肿瘤 吡柔比星 环磷酰胺 白蛋白结合型紫杉醇 新辅助化疗 细胞增殖核抗原 基质金属蛋白酶-9 血管内皮生长因子 预后 

分 类 号：R737.9[医药卫生—肿瘤]