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曲妥珠单抗联合新辅助化疗用于HER2过度表达乳腺癌的临床观察
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| 篇名： | 曲妥珠单抗联合新辅助化疗用于HER2过度表达乳腺癌的临床观察 |
| TITLE： | |
| 摘要： | 目的：探讨曲妥珠单抗联合新辅助化疗用于乳腺癌的临床疗效及安全性，并探讨其对患者肿瘤组织人表皮生长因子受体2（HER2）蛋白、B7同源体1（B7-H1）和白细胞介素2（IL-2）表达的影响。方法：选取经病理活检确诊且免疫组化检测联合荧光原位杂交技术检测结果为HER2过度表达的62例乳腺癌患者为研究对象，按随机数字表法分成观察组和对照组，各31例。对照组患者术前予以卡铂+多西他赛新辅助化疗方案；观察组患者在化疗基础上联合注射用曲妥珠单抗静脉滴注，第1周剂量为4 mg/kg，第2～18周剂量均为2 mg/kg，每周1次，持续治疗18周。化疗结束2周后行乳腺癌改良根治术。观察两组患者的临床疗效及不良反应发生情况，比较两组患者治疗前后病灶组织中HER2蛋白、B7-H1与IL-2表达情况；随访1年，记录两组患者的肿瘤复发、转移及生存率。结果：治疗后，观察组患者的总有效率为83.87％，显著高于对照组的58.06％，差异有统计学意义（P＜0.05）；观察组患者病灶组织的HER2蛋白检测结果为非过度表达者有19例（61.29％），显著多于对照组的11例（35.48％），差异有统计学意义（P＜0.05）；观察组患者病灶组织B7-H1与IL-2表达阳性率显著低于治疗前和对照组治疗后，差异均有统计学意义（P＜0.05）。两组患者不良反应发生率比较，差异无统计学意义（P＞0.05）。在为期1年的随访中，两组患者除生存率比较差异无统计学意义（P＞0.05）外，观察组患者的复发率与转移率均明显低于对照组，差异有统计学意义（P＜0.05）。结论：在乳腺癌改良根治术前应用曲妥珠单抗联合新辅助化疗方案，可有效改善HER2过度表达的乳腺癌患者病灶组织HER2蛋白、B7-H1与IL-2的表达，提高临床疗效，且用药安全，患者术后肿瘤复发、转移的风险较低。 |
| ABSTRACT： | OBJECTIVE： To investigate clinical efficacy and safety of trastuzumab combined with neoadjuvant chemotherapy on breast cancer， and discuss its effects on the expression of HER2 protein， B7 homolog 1 （B7-H1） and IL-2. METHODS： 62 patients with breast cancer confirmed by pathological biopsy， whose test results of immunohistochemistry combined with fluorescence in situ hybridization （FISH） was overexpression of HER2， were selected as the research object. They were randomly divided into observation group and control group with 31 cases in each group. Control group was given carboplatin combined with docetaxel neoadjuvant chemotherapy before surgery. Observation group was additionally given Trastuzumab for injection intravenously 4 mg/kg in the first week， 2 mg/kg in second-eighteenth week， once a week， for consecutive 18 weeks. Modified radical mastectomy was conducted 2 weeks after chemotherapy. Clinical efficacy and the occurrence of ADR were observed in 2 groups. The expression of HER2 protein， B7-H1 and IL-2 in tumor tissues were compared between 2 groups before and after treatment. With 1-year follow-up， tumor recurrence rates， metastasis rates and survival rates were recorded in 2 groups. RESULTS： After treatment， total effective rate of observation group was 83.87％， which was significantly higher than that of control group （58.06％）， with statistical significance （P＜0.05）； the test result of HER2 protein in lesion tissues was non-overexpression in 19 cases （61.29％） in observation group which was significantly higher than that of control group （11 cases， 35.48％）， with statistical significance （P＜0.05）； the positive expression rates of B7-H1 and IL-2 in lesion tissues of observation group were significantly lower than those before treatment and control group after treatment， with statistical significance （P＜0.05）. There was no statistical significance in the incidence of ADR between 2 groups （P＞0.05）. During 1-year follow-up period， except that there was no statistically significant difference in survival rate between 2 groups （P＞0.05）， the recurrence rate and metastasis rate of observation group were significantly lower than those of control group， with statistical significance （P＜0.05）. CONCLUSIONS： The application of trastuzumab combined with neoadjuvant chemotherapy before breast cancer modified radical mastectomy can effectively improve the expression levels of HER2 protein， B7-H1 and IL-2 in lesion tissue of patients with breast cancer， promote clinical efficacy with good safety and low risk of tumor recurrence and metastasis after operation. |
| 期刊： | 2016年第27卷第29期 |
| 作者： | 闫海山，张冰雁 |
| AUTHORS： | YAN Haishan，ZHANG Bingyan |
| 关键字： | 曲妥珠单抗；新辅助化疗；乳腺癌；人表皮生长因子受体2；B7同源体1；白细胞介素2 |
| KEYWORDS： | Trastuzumab； Neoadjuvant chemotherapy； Breast cancer； HER2； B7-H1； IL-2 |
| 阅读数： | 384 次 |
| 本月下载数： | 2 次 |
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