多西他赛联合表柔比星序贯化疗对三阴性乳腺癌相关指标的影响
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摘要
目的观察多西他赛(TXT)联合表柔比星(EPI)序贯化疗对三阴性乳腺癌(TNBC)患者血清癌胚抗原(CEA)、糖类抗原199(CA199)、白细胞介素8(IL-8)等相关指标的影响。方法选取医院2015年1月至2017年9月收治的TNBC患者74例,按随机数字表法分为研究组和对照组,各37例。研究组患者给予TXT+EPI序贯化疗,对照组患者给予TXT+EPI联合化疗。结果与化疗前比较,两组患者化疗后血清CEA,CA199,IL-8,IL-6和人生长分化因子3水平均明显降低(P <0.05),但两组间无明显差异(P> 0.05);与化疗前比较,两组患者化疗后癌细胞乳腺癌耐药蛋白、P-糖蛋白表达水平均明显升高(P <0.05),且研究组明显低于对照组(P <0.05);研究组不良反应发生率明显低于对照组(P <0.05)。结论 TXT+EPI序贯化疗在改善TNBC患者血清肿瘤标志物、细胞因子水平方面与TXT+EPI联合化疗作用相当,但序贯化疗在减轻患者耐药程度和不良反应方面更具优势。
Objective To observe the effect of taxotere(TXT) combined with epirubicin(EPI) sequential chemotherapy on serum levels of carcinoembryonic antigen(CEA),carbohydrate antigen 199(CA199) and interleukin-8(IL-8) in patients with triple negative breast cancer(TNBC).Methods Totally 74 patients with TNBC admitted to our hospital from January 2015 to September 2017 were selected and divided into the study group and the control group according to the random number table method,37 cases in each group.The patients in the study group received TXT + EPI sequential chemotherapy,while the patients in the control group received TXT + EPI combined chemotherapy.Results Compared with before chemotherapy,the levels of serum CEA,CA199,IL-8,IL-6 and human growth differentiation factor-3(GDF3) in the two groups were significantly decreased after chemotherapy(P < 0.05),but there was no significant difference between the two groups(P > 0.05).Compared with before chemotherapy,the expression levels of breast cancer resistance protein(ABCG2),P-glycoprotein(P-gp) in breast cancer cells of the two groups were significantly increased after chemotherapy,but those in the study group were significantly lower than those in the control group(P < 0.05).The incidence rate of adverse reactions in the study group was significantly lower than that in the control group(P < 0.05).Conclusion TXT + EPI sequential chemotherapy and TXT + EPI combined chemotherapy have a similar role in improving levels of serum tumor markers and cytokines.However,sequential chemotherapy has more advantages in reducing drug resistance and adverse reactions.
Objective To observe the effect of taxotere(TXT) combined with epirubicin(EPI) sequential chemotherapy on serum levels of carcinoembryonic antigen(CEA),carbohydrate antigen 199(CA199) and interleukin-8(IL-8) in patients with triple negative breast cancer(TNBC).Methods Totally 74 patients with TNBC admitted to our hospital from January 2015 to September 2017 were selected and divided into the study group and the control group according to the random number table method,37 cases in each group.The patients in the study group received TXT + EPI sequential chemotherapy,while the patients in the control group received TXT + EPI combined chemotherapy.Results Compared with before chemotherapy,the levels of serum CEA,CA199,IL-8,IL-6 and human growth differentiation factor-3(GDF3) in the two groups were significantly decreased after chemotherapy(P < 0.05),but there was no significant difference between the two groups(P > 0.05).Compared with before chemotherapy,the expression levels of breast cancer resistance protein(ABCG2),P-glycoprotein(P-gp) in breast cancer cells of the two groups were significantly increased after chemotherapy,but those in the study group were significantly lower than those in the control group(P < 0.05).The incidence rate of adverse reactions in the study group was significantly lower than that in the control group(P < 0.05).Conclusion TXT + EPI sequential chemotherapy and TXT + EPI combined chemotherapy have a similar role in improving levels of serum tumor markers and cytokines.However,sequential chemotherapy has more advantages in reducing drug resistance and adverse reactions.
引文
[1]洪进,陈小松,吴佳毅,等.三阴性乳腺癌辅助化疗决策的影响因素分析[J].中华肿瘤杂志,2017,39(1):39-43.
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[10]汤继英,汪选斌,蔡晓军,等.血清CEA和CA19-9水平与乳腺癌化疗疗效及预后的关系[J].中国普通外科杂志,2016,25(6):934-938.
[11]杨明德,李冬梅,于慧玲.化疗前后乳腺癌患者血清中IL-6、IL-8及TNF-α的变化及意义[J].中国妇幼保健,2015,30(1):136-138.
[12]何建明,肖宏卫,谭丽珊,等.三阴性乳腺癌组织CaSR和ABCG2表达临床意义研究[J].中华肿瘤防治杂志,2017,24(12):817-822.
[13]杨海松,毛大华,张世泳,等.紫杉醇联合表阿霉素新辅助化疗治疗三阴性乳腺癌的临床疗效评价及其对Ki-67、p53、P-gp和GST-π的影响[J].现代生物医学进展,2017,17(22):4281-4284.
[14]王薇,别克扎提·再孜提汉,周静,等.多西紫杉醇联合表阿霉素序贯化疗治疗三阴性乳腺癌的效果观察[J].山东医药,2018,58(4):79-81.
[2]李东,张敬.三阴乳腺癌ET与AC→T化疗方案疗效比较[J].湖南中医药大学学报,2016,36(A02):1113.
[3]中国女医师协会临床肿瘤学专业委员会.中国进展期乳腺癌共识指南(CABC2015)[J].癌症进展,2015,13(3):223-245.
[4]李俏,徐兵河,李青,等.顺铂联合卡培他滨治疗蒽环和紫杉类耐药晚期三阴性乳腺癌的近期疗效与安全性[J].中华肿瘤杂志,2015,37(12):938-941.
[5]郭伟,金功胜.多西紫杉醇和表阿霉素新辅助化疗对三阴性乳腺癌的临床疗效评价[J].中国临床药理学杂志,2015,31(24):2381-2383.
[6]王玻玮,马方婧,刘铭,等.表阿霉素对乳腺癌细胞系的作用效应[J].新疆医科大学学报,2015,38(12):1520-1523.
[7]寇长元,李恩孝.表阿霉素联合多西紫杉醇治疗三阴性与非三阴性乳腺癌比较[J].山西医药杂志,2016,45(14):1667-1669.
[8]黄河清,钟慕仪,林伟强,等.多西紫杉醇联合吡柔比星新辅助化疗治疗不同亚型乳腺癌患者的疗效及病理完全缓解状况分析[J].山西医药杂志,2017,46(21):2556-2559.
[9]王芳,刘新兰,金晓菲.血清CEA、CA15-3在乳腺癌转移监测中的临床意义[J].宁夏医科大学学报,2017,39(6):687-689.
[10]汤继英,汪选斌,蔡晓军,等.血清CEA和CA19-9水平与乳腺癌化疗疗效及预后的关系[J].中国普通外科杂志,2016,25(6):934-938.
[11]杨明德,李冬梅,于慧玲.化疗前后乳腺癌患者血清中IL-6、IL-8及TNF-α的变化及意义[J].中国妇幼保健,2015,30(1):136-138.
[12]何建明,肖宏卫,谭丽珊,等.三阴性乳腺癌组织CaSR和ABCG2表达临床意义研究[J].中华肿瘤防治杂志,2017,24(12):817-822.
[13]杨海松,毛大华,张世泳,等.紫杉醇联合表阿霉素新辅助化疗治疗三阴性乳腺癌的临床疗效评价及其对Ki-67、p53、P-gp和GST-π的影响[J].现代生物医学进展,2017,17(22):4281-4284.
[14]王薇,别克扎提·再孜提汉,周静,等.多西紫杉醇联合表阿霉素序贯化疗治疗三阴性乳腺癌的效果观察[J].山东医药,2018,58(4):79-81.