多西他赛、表柔比星联合环磷酰胺对不同分子分型乳腺癌患者临床疗效及肿瘤标志物表达的影响-中国药房

多西他赛、表柔比星联合环磷酰胺对不同分子分型乳腺癌患者临床疗效及肿瘤标志物表达的影响

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篇名：	多西他赛、表柔比星联合环磷酰胺对不同分子分型乳腺癌患者临床疗效及肿瘤标志物表达的影响
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摘要：	目的：探讨多西他赛、表柔比星联合环磷酰胺为新辅助化疗（NAC）方案对不同分子分型乳腺癌患者临床疗效及肿瘤标志物表达的影响。方法：选取2014年1月－2016年1月我院局部晚期乳腺癌女性患者88例，依据分子分型分为Luminal A型（23例）、Luminal B型（21例）、基底细胞型（11例）、HER2过表达型（18例）和正常乳腺样型（15例）。所有患者均予多西他赛注射液+盐酸表柔比星注射液+注射用环磷酰胺连续治疗6个周期（每21 d为1个周期），比较各分子分型乳腺癌患者的总有效率和病理完全缓解（pCR）率，以及治疗前后血清中肿瘤标志物[癌胚抗原（CEA）、糖蛋白（CA）125、CA153]的表达水平，记录不良反应的发生情况。结果：88例患者的总有效率为63.64％，其中基底细胞型乳腺癌患者的总有效率为72.73％，显著高于其他分子分型患者，差异均有统计学意义（P＜0.05）；而其他各分子分型患者总有效率两两比较，差异均无统计学意义（P＞0.05）。88例患者的pCR率为27.27％，以基底细胞型乳腺癌患者的pCR率最高（45.45％）；除HER2过表达型与正常乳腺样型患者pCR率无明显差异（P＞0.05）外，其余各分子分型患者pCR率两两比较，差异均有统计学意义（P＜0.05）。治疗前，各分子分型乳腺癌患者血清中CEA、CA125、CA153的表达水平比较，差异均无统计学意义（P＞0.05）；治疗后，各分子分型患者CEA、CA125、CA153的表达水平均较治疗前显著降低，差异均有统计学意义（P＜0.05）；但各分子分型患者上述标志物表达水平比较，差异均无统计学意义（P＞0.05）。各分子分型乳腺癌患者总不良反应发生率比较，差异无统计学意义（P＞0.05）。结论：多西他赛、表柔比星联合环磷酰胺的NAC方案可降低乳腺癌患者体内肿瘤标志物的表达水平，对各分子分型乳腺癌均有一定的治疗效果。基底细胞型乳腺癌患者的总有效率和pCR率优于其他各分子分型患者，该NAC方案可作为基底细胞型乳腺癌的首选治疗方案。
ABSTRACT：	OBJECTIVE： To investigate the effects of neoadjunctive chemotherapy （NAC） of docetaxel and epirubicin combined with cyclophosphamide on clinical efficacy and tumor markers of breast cancer patients with different molecular types. METHODS： A total of 88 female patients with locally advanced breast cancer collected from our hospital during Jan. 2014-Jan. 2016 were divided into Luminal A type （23 cases）， Luminal B type （21 cases）， basal-like type （11 cases）， HER2-over expressing type （18 cases） and normal breast-like type （15 cases） according to molecular type. All patients were given Docetaxel injection+Epirubicin hydrochloride injection+Cyclophosphamide for injection for consecutive 6 cycles （21 d as a cycle）. Total response rates and pathological complete remission （pCR） rates were compared among breast cancer patients with different molecular types. The expression of serum tumor markers [CEA， CA125， CA153] were compared before and after treatment， and the occurrence of ADR was recorded. RESULTS： Total response rate of 88 patients was 63.64％， among which that of basal-like breast cancer patients was 72.73％， significantly higher than other molecular types， with statistical significance （P＜0.05）. There was no statistical significance in total response rates of pairwise molecular type comparison （P＞0.05）. The pCR rate of 88 patients was 27.27％， and that of basal-like breast cancer patients was the highest （45.45％）. There was statistical significance in pCR rates of pairwise molecular type comparison （P＜0.05）， except there was no significant difference in pCR rate between HER2-over expressing type and normal breast-like type （P＞0.05）. Before treatment， there was no statistical significance in the expression of CEA， CA125 and CA153 in breast cancer patients with different molecular types （P＞0.05）. After treatment， the expression of CEA， CA125 and CA153 in different molecular types were decreased significantly， with statistical significance （P＜0.05）. There was no statistical significance in the expression of above markers among different molecular types （P＞0.05）. There was no statistical significance in the incidence of ADR among different molecular types （P＞0.05）. CONCLUSIONS： NAC plan of docetaxel and epirubicin combined with cyclophosphamide can reduce the expression of tumor markers and shows certain therapeutic efficacy for breast cancer patients with different molecular types. Total response rate and pCR rate of basal-like type are better than those of other molecular types， so NAC plan is the preferred treatment for basal-like type breast cancer.
期刊：	2017年第28卷第23期
作者：	王松，薛文华，赵晓玉，梁艳，齐跃东，康健，高明
AUTHORS：	WANG Song，XUE Wenhua，ZHAO Xiaoyu，LIANG Yan，QI Yuedong，KANG Jian，GAO Ming
关键字：	多西他赛；表柔比星；环磷酰胺；新辅助化疗；乳腺癌；分子分型；病理完全缓解；肿瘤标志物
KEYWORDS：	Docetaxel； Epirubicin； Cyclophosphamide； Neoadjunctive chemotherapy； Breast cancer； Molecular type； Pathological complete remission； Tumor markers
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