奥拉帕利辅助治疗对乳腺癌非保乳手术术后病理阳性患者预后、腋窝局部复发和远处复发的影响  

Effect of olaparib adjuvant therapy on prognosis,axillary local recurrence and distant recurrence of breast cancer patients with positive pathology after non-breast conserving surgery

作　　者：刘军[1] 陈成玲 李昌文[1] 王伟[1] 孙丽[2] LIU Jun;CHEN Cheng-ling;LI Chang-wen(Department of Breast Surgery,Xuzhou Central Hospital,Xuzhou Jiangsu 221009,China)

机构地区：[1]徐州市中心医院乳腺外科,江苏徐州221009 [2]徐州市中心医院肿瘤内科,江苏徐州221009

出　　处：《临床和实验医学杂志》2023年第6期628-632,共5页Journal of Clinical and Experimental Medicine

基　　金：国家自然科学基金(编号:BK20191355)。

摘　　要：目的探究奥拉帕利辅助治疗对乳腺癌非保乳手术术后病理阳性患者预后,腋窝局部复发和远处复发的影响。方法本研究为回顾性分析,选择2012年3月至2017年6月徐州市中心医院收治的60例乳腺癌非保乳手术治疗患者为研究对象,按照随机数字表法分为观察组(n=30)和对照组(n=30)。对照组开展多西紫杉醇、顺铂联合治疗,观察组在对照组治疗的基础上,予以奥拉帕利辅助治疗。比较肿瘤标志物[癌胚抗原(CEA)、糖链抗原(CA)-199和CA242]水平、机体免疫功能、细胞凋亡因子[B淋巴细胞瘤-2(Bcl-2)、可溶性细胞凋亡因子(sFas)、Bcl-2结合抗凋零基因-1(Bag-1)]、复发情况、不良反应。结果治疗后,两组CEA、CA199、CA242水平均较治疗前降低,且观察组分别为(16.56±2.36)μg/L、(49.96±6.25)U/mL、(98.56±10.25)U/mL,均低于对照组[(20.25±2.54)μg/L、(58.12±6.92)U/mL、(112.25±11.66)U/mL],差异均有统计学意义(P<0.05)。治疗后,两组CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平均较治疗前升高,CD8^(+)均较治疗前降低,且观察组CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)分别为(55.69±5.05)%、(56.58±5.16)%、1.96±0.31,均高于对照组[(50.95±5.11)%、(50.25±5.89)%、1.64±0.24],CD8^(+)为(28.89±2.65)%,低于对照组[(30.65±2.12)%],差异均有统计学意义(P<0.05)。治疗后,两组Bcl-2、sFas、Bag-1水平均较治疗前降低,Bax水平均较治疗前升高,且观察组Bcl-2、sFas、Bag-1水平为(0.85±0.13)ng/mL、(13.52±1.82)ng/mL、(10.25±1.12)μg/mL,均低于对照组[(1.39±0.22)ng/mL、(16.98±1.58)ng/mL、(15.62±2.35)μg/mL],Bax水平为(3.82±0.52)ng/mL,高于对照组[(3.29±0.50)ng/mL],差异均有统计学意义(P<0.05)。观察组局部复发率、远处复发率分别为0、13.33%,均低于对照组(11.76%、26.67%);观察组5年内生存率为96.67%,高于对照组(73.33%),差异均有统计学意义(P<0.05)。观察组不良反应总发生率为23.33%,对照组不良反应总发生率为16.67%,观察组与�Objective To explore the effect of olaparib adjuvant therapy on the prognosis,axillary local recurrence and distant recurrence of breast cancer patients with positive pathology after non-breast conserving surgery.Methods This study was a retrospective analysis,and 60 patients with breast cancer admitted to Xuzhou Central Hospital from March 2012 to June 2017 were selected as the study subjects,the random number table method was used to divided the patiens into group,observation group(n=30)and control group(n=30).The control group was treated with docetaxel and cisplatin,while the observation group was treated with olaparib based on the control group.The levels of tumor markers[carcinoembryonic antigen(CEA),glycan antigen-199(CA)and CA242],immune function,apoptotic factors[B-lymphoblastoma-2(Bcl-2),soluble apoptosis factor(sFas),Bcl-2 binding anti-withering gene-1(Bag-1)],recurrence and adverse reactions were compared.Results After treatment,the levels of CEA,CA199 and CA242 in the two groups were lower than those before treatment,and the levels in the observation group were(16.56±2.36)μg/L,(49.96±6.25)U/mL,(98.56±10.25)U/mL,respectively,which were lower than those in the control group[(20.25±2.54)μg/L,(58.12±6.92)U/mL,(112.25±11.66)U/mL],the differences were statistically significant(P<0.05).After treatment,the levels of CD3^(+),CD4^(+),CD4^(+)/CD8^(+)in both groups were higher than those before treatment,and the level of CD8^(+)was lower than that before treatment,and the levels of CD3^(+),CD4^(+),CD4^(+)/CD8^(+)in the observation group were(55.69±5.05)%,(56.58±5.16)%,(1.96±0.31),which were higher than those in the control group[(50.95±5.11)%,(50.25±5.89)%,(1.64±0.24)],and the level of CD8^(+)was(28.89±2.65)%,which was lower than that in the control group[(30.65±2.12)%],the differences were statistically significant(P<0.05).After treatment,the levels of Bcl-2,sFas and Bag-1 in both groups were lower than those before treatment,and the level of Bax was higher than those before treatment.The levels

关 键 词：奥拉帕利 乳腺癌 肿瘤标志物 机体免疫功能 局部复发 

分 类 号：R737.9[医药卫生—肿瘤]