三阴性乳腺癌的活化T细胞免疫表型与免疫治疗疗效的临床研究

The Clinical Study The Significance of Immunophenotype in the Active T cells between the Triple Negative Breast Cancer of Relapse and Metastasis with The Not Triple Negative Breast Cancer Therapy With or Without Thymopeptides α_1(Tα_1) combination chemot

目的探讨复发转移三阴性乳腺癌与非三阴性乳腺癌活化T细胞免疫表型的差异及意义,并观察化疗联合胸腺肽a1与单独化疗相比对三阴性乳腺癌生存影响的差异。方法对60例复发转移的三阴性乳腺癌患者,测定活化T细胞免疫表型,与非三阴乳腺癌患者活化T细胞免疫表型比较。60例随机分为两组,A组给予化疗联合免疫增强剂治疗,胸腺肽α11.6mg,每周二次,共3个月;B组单独化疗,(两组化疗方案相似TX,TAorTE,NP,GP),比较两组的ORR(有效率),PFS(无疾病进展时间),总生存期(OS)及生活质量KPS评分。结果三阴性乳腺癌患者活化T细胞免疫表型结果明显低于非三阴性乳腺癌患者,有显著性统计学意义(P<0.05)。三阴性乳腺癌给予免疫增强剂胸腺肽a1加化疗组与单独化疗组相比,两组的ORR(总有效率):A组27例(63.0%)和B组21例(51.6%),比较无明显统计学意义,而CR17例(29.7%)比10例(16.6%),P<0.001,有明显统计学意义。PFS(无疾病进展时间)两组12月比7月,A组优于对照组,P<0.05,有明显的统计学意义。一年总生存期(OS)两组无明显统计差异。症状体征的生活质量改善,A组KPS提高,明显优于对照组(P<0.01)。结论三阴性乳腺癌患者活化T细胞免疫表型明显低于非三阴性乳腺癌患者,免疫功能低下,预后差。免疫增强剂胸腺肽a1可提高三阴性乳腺癌患者ORR(总有效率),CR率及PFS(无疾病进展时间),并可提高患者生活质量,值得临床进一步推广应用。

Objective to study the difference and significance of immunophenotype in the active T cells between the Triple negative breast cancer of relapse and metastasis with the not Triple negative breast cancer, and observe the survival difference of the Triple negative breast cancer between chemotherapy combination with or without Thymopeptides α1 （Tα1）. Methods To determine the immunophenotype of the active T cells in 60 cases triple negative breast cancer patients of relapse and metastasis, and compare with the not triple negative breast cancer patients. 60 cases triple negative breast cancer patients randomly divided into two groups, the group A with chemotherapy combination immunopotentiators strength agent treatment,witch is Tα1 1.6 mg, twice a week for three months; Group B with chemotherapy alone, compared with two groups of ORR, CR, PFS, or OS and the quality of life KPS score. Results The immunophenotype of the active T cells in triple negative breast cancer patients were obviously lower than the not triple negative breast cancer, it has statistical significance （P〈0.05）. Comparing the ORR of the triple negative breast cancer to give the immune strength agent Tα1 and chemotherapy group with only chemotherapy group, Tα1 group has 27 cases （63.0%） and the other group has 21 cases （51.6%）, it has no obvious statistical significance. But the CR is 17 （29.7%） to 10 （16.6%）, have obvious statistical significance （P〈0.01）. PFS two groups are 12 to 7 and the Tα1 group more than the control group, there are obvious statistical significance （P〈0.05）. A year OS no difference between the two groups. Signs and symptoms improvement in quality of life, the KPS of the Tα1 group was obviously improved than the control group （P〈0.01）. Conclusion triple negative breast cancer patients activate T ceils obviously lower than the immunephenotype triple negative breast cancer patients, and triple negative breast cancer have lower immune function and poorer prognosis. The immunopotentiators Tα1 can impove ORR, CR and PFS, and can increase the quality of life and worth clinical further popularized.