乳腺癌患者术前新辅助化疗效果及对肿瘤标志物的影响

Efficacy of preoperative neoadjuvant chemotherapy and its effect on tumor markers in patients with breast cancer

目的探讨乳腺癌患者术前采用新辅助化疗的治疗效果及对肿瘤标志物的影响。方法选取2015年3月至2018年4月间辽宁中置盛京老年病院收治的96例行手术治疗的Ⅱ~Ⅲ期初治女性乳腺癌患者,采用随机数表法分为联合组和对照组,每组48例。联合组患者采用紫杉醇联合表阿霉素(PE方案)新辅助化疗治疗,对照组患者采用环磷酰胺+表阿霉素+5-氟尿嘧啶(CEF方案)新辅助化疗治疗,手术治疗前评价两组患者总有效率、化疗不良反应和肿瘤标志物。结果联合组患者总有效率为79.2%,高于对照组的60.4%,差异有统计学意义(P<0.05)。两组患者不良反应多处于Ⅰ~Ⅲ度,主要表现为白细胞减少、轻度的心脏毒性和肝功能异常及恶性呕吐,通过对症治疗,患者均可耐受,两组患者不良反应发生率比较,差异无统计学意义(P>0.05)。治疗前,两组患者血清肿瘤标志物比较,差异无统计学意义(P>0.05)。治疗后,两组患者血清肿瘤标志物均降低(P<0.05),且联合组患者CRA和CA125低于对照组,但差异无统计学意义;CA153低于对照组,差异有统计学意义(P<0.05)。结论乳腺癌患者手术前应用紫杉醇联合表阿霉素新辅助化疗,能有效缩小肿瘤体积,提高总有效率,降低不良反应和血清肿瘤标志物,提高乳腺癌根治切除率,值得临床推广应用。

Objective To observe the efficacy of preoperative neoadjuvant chemotherapy and its effect on tumor markers in patients with breast cancer.Methods Ninety-six patients with stage II to III breast cancer who were undergoing surgery at Liaoning Zhongzhi Shengjing Hospital of Geriatrics from March2015 to April 2018 were enrolled in the present study.The random number chart was used and the patients were divided into a combination group and a control group with 48 patients in each group.The combination group was treated with neoadjuvant chemotherapy of paclitaxel plus epirubicin(PE)and the control group was treated with neoadjuvant chemotherapy of cyclophosphamide plus epirubicin and 5-fluorouracil(CEF).The overall efficacy rate,adverse reactions associated with chemotherapy and levels of tumor markers were evaluated before the surgery.Results The overall efficacy was 79.2%in the combination group,which was significantly higher than 60.4%of the control group(all P<0.05).Adverse reactions were mostly gradeⅠtoⅢ,which included leukocytopenia,mild cardiotoxicity,liver dysfunction and nausea and vomiting.The adverse reactions became tolerable after symptomatic treatment and there were no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Before the treatment,there was no significant difference in the serum tumor markers between the two groups(P>0.05).After the treatment,the serum tumor markers decreased in the two groups compared with before the treatment(all P<0.05).The levels of CRA and CA125 were lower in the combination group than in the control group,but the difference was not statistically significant(P>0.05).However,the level of CA153 was significantly lower in the combination group than in the control group and the differences between the two groups were significant(P<0.05).Conclusion Neoadjuvant chemotherapy with paclitaxel combined with epirubicin can effectively reduce tumor volume,increase overall efficiency,reduce incidence of adverse reactions and serum tumor markers,and improve the radical resection rate for breast cancer.It deserves clinical promotion and application.