消癌平对乳腺癌新辅助化疗疗效的增强作用及其机制探讨

Study on effect of Xiaoaiping in enhancing efficacy of neoadjuvant chemotherapy for breast cancer and its mechanism

中药消癌平具有抗乳腺癌的药理活性,新辅助化疗近年来在乳腺癌治疗中广泛开展,然而消癌平与新辅助化疗联合治疗乳腺癌的临床疗效及机制尚未见文献报道。选择66例接受乳腺癌择期手术的乳腺癌患者作为研究对象。采用随机数表法,将上述患者平均分为对照组及治疗组。所有患者在术前接受西他赛+表柔比星+环磷酰胺(TEC)方案的新辅助治疗,而治疗组患者还在此基础上联用消癌平注射液(60 m L,静脉滴注,1次/d)进行辅助治疗。观察并比较2组患者治疗的近期治疗有效率以及随访生存率;采集患者手术标本,用免疫组织化学法对2组患者乳腺癌标本中雌激素受体α36(ER-α36)表达水平进行观察与比较。治疗组近期临床治疗总有效率为78.79%,较对照组的57.58%显著升高(χ2=5.48,P<0.05)。与对照组相比,治疗组3年及5年的无病生存率和总生存率均显著升高(P<0.05);与对照组相比,治疗组乳腺癌组织中ER-α36表达水平显著降低(P<0.05)。由结果可以总结,中药消癌平能够显著提高乳腺癌新辅助化疗近期及远期疗效,可能机制与抑制乳腺癌组织中ER-α36的表达有关。

Traditional Chinese medicine （TCM） Xiaoaiping shows a pharmacological activity in treatment of breast cancer. Although neoadjuvant chemotherapy has been more and more widely used in treatment of breast cancer in recent years, no report has been made about the clinical efficacy and mechanism of the combined application of neoadjuvant chemotherapy and Xiaoaiping in treatment of breast cancer. In this study, 66 patients with breast cancer were selected and divided into the control group and the treatment group evenly with the random number table method. All patients received TEC neoadjuvant chemotherapy. On that basis, the treatment group also received the adjuvant therapy of Xiaoaiping injection （60 mL, i.v., qd）. The short-term response rate and the follow-up survival rate of the two groups were observed and compared. Surgical specimens of the patient were collected to observe and compare their expressions of estrogen receptor ER-α36 in breast cancer tissues with the immunohistochemical method. According to the findings, the overall response rate of the treatment group was 78.79%, which was significantly higher than that of the control group （57.58%, χ2=5.48, P〈0.05）. Compared with the control group, the treatment group showed significant increases in the disease-free survival （DFS） rate and the total survival rate at the 3rd year and 5th year （all P〈0.05）, and a notable reduction in ER-α36 expression in breast cancer tissues （P〈0.05）. Based on the our results, Xiaoaiping can significantly enhance short-term ad long-term efficacies of neoadjuvant chemotherapy for breast cancer. Its mechanism may be correlated with the inhibition of ER-α36 expression in breast cancer tissues.keywords：breast cancer