曲妥珠单抗辅助治疗HER2阳性乳腺癌患者的效果  

Effect of Trastuzumab in Adjuvant Treatment of HER2-Positive Breast Cancer

作　　者：吴孟瑶 张贵州 李婉 WU Mengyao;ZHANG Guizhou;LI Wan(Comprehensive Treatment Room,Nanyang Central Hospital,Nanyang 473000,China)

机构地区：[1]南阳市中心医院综合治疗室,河南南阳473000

出　　处：《河南医学研究》2025年第4期694-698,共5页Henan Medical Research

摘　　要：目的分析曲妥珠单抗辅助治疗人类表皮生长因子受体2(HER2)阳性乳腺癌(BC)患者的效果及对血清结合素4(nectin-4)、黏蛋白1(MUC1)、骨桥蛋白(OPN)水平的影响。方法选择2021年1月至2023年1月南阳市中心医院收治的HER2阳性BC患者86例,随机分为研究组、对照组,各43例。研究组接受曲妥珠单抗辅助紫杉醇、卡铂治疗,对照组接受紫杉醇、卡铂治疗,3周为1个疗程,两组均治疗4个疗程。比较两组治疗4个疗程后疗效,治疗前、治疗4个疗程后血清nectin-4、MUC1、OPN水平、肿瘤标志物、心肌损伤、安全性。结果治疗4个疗程后,研究组总有效率更高(65.12%比41.86%,P<0.05)。较治疗前,治疗4个疗程后两组血清nectin-4、MUC1、OPN、糖类抗原(CA)125、CA15-3、癌胚抗原(CEA)水平降低,且研究组更低(P<0.05)。较治疗前,治疗4个疗程后,两组血清心肌肌钙蛋白I(cTnI)、氨基末端B型脑钠肽前体(NT-proBNP)、肌酸激酶同工酶(CK-MB)水平均升高(P<0.05),但两组比较差异无统计学意义(P>0.05)。治疗期间,两组血小板下降、白细胞下降、骨髓抑制、恶心呕吐、肝功能异常、腹泻发生率差异无统计学意义(P>0.05)。结论曲妥珠单抗辅助治疗HER2阳性BC,能提高效果,下调血清nectin-4、MUC1、OPN水平,控制肿瘤标志物表达,安全性好。Objective To analyze the therapeutic effect of trastuzumab in the adjuvant treatment of human epidermal growth factor receptor 2(HER2)positive breast cancer(BC)patients and the influence of serum levels of binding hormone 4(nectin-4),mucin 1(MUC1)and osteopontin(OPN).Methods A total of 86 patients with HER2-positive BC admitted to Nanyang Central Hospital from January 2021 to January 2023 were randomly divided into the study group(43 cases)and the control group(43 cases).The study group received trastuzumab assisted paclitaxel and carboplatin treatment,and the control group received paclitaxel and carboplatin treatment,3 weeks as 1 course,both groups were treated for 4 courses.The efficacy of the two groups after 4 courses of treatment,serum levels of nectin-4,MUC1,OPN,tumor markers,myocardial injury,and adverse reactions during treatment before and after 4 courses of treatment were compared.Results The total effective rate of the study group after 4 courses of treatment was higher(65.12%vs 41.86%,P<0.05).After 4 courses of treatment,the serum levels of nectin-4,MUC1,OPN,carbohydrate antigen(CA)125,CA15-3 and carcinoembryonic antigen(CEA)in the two groups decreased,and those were lower in the study group(P<0.05).Compared with before treatment,after 4 courses of treatment,serum levels of cardiac troponin I(cTnI),amino terminal B-type brain natriuretic peptide precursor(NT-proBNP)and creatine kinase isoenzyme(CK-MB)of both groupsincreased,but there was no statistical difference between the two groups(P>0.05).During treatment,there was no significant difference in the incidence of thrombocytopenia,leukopenia,bone marrow depression,nausea and vomiting,abnormal liver function and diarrhea between the two groups(P>0.05).Conclusion Trastuzumab adjuvant therapy for HER2-positive BC can improve the effect,down-regulate the levels of serum nectin-4,MUC1 and OPN,and control the expression of tumor markers,with good safety.

关 键 词：乳腺癌 人类表皮生长因子受体2 曲妥珠单抗 结合素4 黏蛋白1 骨桥蛋白 肿瘤标志物 心肌损伤 

分 类 号：R737.9[医药卫生—肿瘤]