曲妥珠单抗联合化疗方案治疗乳腺癌的疗效及其作用机制研究  

Efficacy and mechanism of Trastuzumab combined with chemotherapy in the treatment of breast cancer

作　　者：陆佳团 王征[1] 张浩[1] LU Jia-tuan;WANG Zheng;ZHANG Hao(WardⅠ,Breast Department,Nanyang Central Hospital,Nanyang 473200,Henan,CHINA)

机构地区：[1]南阳市中心医院乳腺科一病区,河南南阳473200

出　　处：《海南医学》2023年第15期2154-2158,共5页Hainan Medical Journal

基　　金：河南省科技攻关计划项目(编号:222102310474)。

摘　　要：目的评价曲妥珠单抗联合化疗方案治疗乳腺癌(BC)的疗效,并探讨其对患者外周血磷脂酰肌醇-3-激酶(PI3K)/蛋白激酶B(Akt)通路的干预作用。方法选取2019年3月至2021年1月南阳市中心医院乳腺科一病区收治的68例BC患者为研究对象,采用奇偶分组法分为单一组和联合组各34例。单一组患者予以TP方案(紫杉醇+顺铂)化疗,联合组患者予以曲妥珠单抗+TP方案化疗,两组连续治疗3个周期。比较两组患者的临床疗效及治疗前后的血清肿瘤标志物[癌胚抗原(CEA)、糖类抗原125(CA125)、糖类抗原153(CA153)]、生化指标[血小板第4因子(PF4)、中期因子(MK)、脂质运载蛋白-2(LCN-2)]水平;比较两组患者治疗前后的外周血PI3K/Akt通路相关蛋白[磷酸化磷脂酰肌醇-3-激酶(p-PI3K)、磷酸化蛋白激酶B(p-AKT)]表达量、生活质量[欧洲癌症研究与治疗组织生命质量测定量表(EORTC QLQ-C30)]及毒副反应发生率。随访1年后,比较两组患者的生存率。结果联合组患者的治疗总有效率、疾病控制率分别为44.12%、79.41%,明显高于单一组的20.59%、47.06%,差异均有统计学意义(P<0.05);治疗后,联合组患者的血清CEA、CA125、CA153、PF4、MK、LCN-2水平和p-PI3K、p-AKT蛋白表达量明显低于单一组,差异均有统计学意义(P<0.05);治疗后,联合组患者的EORTC QLQ-C30评分为(116.32±9.13)分,明显高于单一组的(101.24±8.46)分,差异有统计学意义(P<0.05);联合组患者的总生存率为93.75%,明显高于单一组的72.41%,差异有统计学意义(P<0.05);两组患者的毒副反应发生率比较差异无统计学意义(P>0.05)。结论曲妥珠单抗联合TP化疗方案可提高BC患者的临床疗效,降低肿瘤标志物和生化指标水平,提高生存率,且具有一定安全性,其可能通过抑制PI3K/Akt通路活化发挥作用。Objective To evaluate the efficacy of Trastuzumab combined with chemotherapy in the treatment of breast cancer(BC),and to explore its intervention effect on the phosphatidylinositol-3-kinase(PI3K)/protein kinase B(Akt)pathway in peripheral blood.Methods Sixty-eight BC patients admitted to WardⅠ,Breast Department,Nanyang Central Hospital from March 2019 to January 2021 were selected as the research subjects.The patients were divided into a single group(n=34)and a combined group(n=34)using parity grouping method.The single group received TP regimen(paclitaxel+cisplatin)chemotherapy,while the combined group received Trastuzumab+TP regimen chemotherapy,both continuously for three cycles.The clinical efficacy and serum tumor markers[carcinoembryonic antigen(CEA),carbohydrate antigen 125(CA125),carbohydrate antigen 153(CA153)],biochemical indicators[platelet factor 4(PF4),mid-term factor(MK),and lipid carrier protein-2(LCN-2)]levels before and after treatment were compared between the two groups.The expression levels of peripheral blood PI3K/Akt pathway related proteins[phosphorylated phosphatidylinositol-3-kinase(p-PI3K),phosphorylated protein kinase B(p-AKT)],quality of life(EORTC QLQ-C30),and incidence of toxic side effects were compared between the two groups before and after treatment.After a one-year follow-up,the survival rates of the two groups of patients were compared.Results The total effective rate and disease control rate of the combined group were 44.12%and 79.41%,respectively,which were significantly higher than 20.59%and 47.06%of the single group(P<0.05).After treatment,the serum levels of CEA,CA125,CA153,PF4,MK,LCN-2,and the expression of p-PI3K,p-AKT proteins in the combined group were significantly lower than those in the single group(P<0.05).After treatment,the EORTC QLQ-C30 score of patients in the combined group was(116.32±9.13)points,significantly higher than(101.24±8.46)points of patients in the single group(P<0.05).The overall survival rate of patients in the combined group was 93.75%,signi

关 键 词：乳腺癌 曲妥珠单抗 化疗 PI3K/AKT通路 疗效 

分 类 号：R737.9[医药卫生—肿瘤]