乌苯美司胶囊在三阴乳腺癌化疗中的临床价值

Administration of ubenimex for patients with triple-negative breast cancer in chemotherapy

目的观察乌苯美司胶囊在三阴乳腺癌化疗过程中对患者免疫功能的影响和对骨髓抑制的干预。方法选择72例三阴乳腺癌患者入组,随机分为治疗组(40例)和对照组(32例)。两组临床资料差异无统计学意义(P>0.05)。患者均行EC(表柔比星、环磷酰胺)-T(多西他赛)的方案化疗。治疗组在化疗期间及化疗后6月内均加服乌苯美司胶囊30 mg每天清晨空腹1次,治疗组与对照组其他辅助用药相同。采用流式细胞法检测EC-T化疗前、后及化疗结束后6月患者静脉血T淋巴细胞亚群、自然杀伤细胞(NK细胞)免疫功能和外周全血细胞指标的变化,评估乌苯美司胶囊在三阴乳腺癌化疗中对T抑制、杀伤淋巴细胞以及NK细胞和外周全血细胞的作用。结果比较EC-T化疗前、后及化疗后6月T抑制/杀伤淋巴细胞(CD3、CD4、CD8、CD19)、自然杀伤细胞(CD16、CD56)变化的差异性,治疗组与对照组差异有统计学意义(均P<0.05)。比较EC-T化疗前、后及化疗后6月外周全血细胞(WBC、RBC、PLT)变化的差异性,治疗组与对照组差异有统计学意义(均P<0.05)。结论乌苯美司胶囊在三阴乳腺癌患者化疗过程中的应用改善化疗药物对患者免疫功能的影响,减轻骨髓抑制的程度,保障患者顺利完成整个化疗过程,减轻化疗药物的近期和远期不良反应。

Objective To evaluate the immune and bone marrow protection effects of ubenimex for patients with triple-negative breast cancer（ TNBC） in chemotherapy. Methods Seventy-two patients with triple-negative breast cancer were randomly assigned into two groups： 40 cases received chemotherapy（ EC-T regimen： EC： epirubicin,cyclophosphamide; T： docetaxel.） with ubenimex（ 30 mg before breakfast）（ ubenimex group） and 32 cases received chemotherapy alone（ control group）. Peripheral CD3,CD4,CD8,CD19 T-cells and natural killer（ NK） cells were measured by flow cytometry and white cells（ WBC）,red cells（ RBC） and platelets（ PLT） in peripheral blood were also measured before and after chemotherapy. All patients were followed up for 6 months. Results Changes in the levels of CD3,CD4,CD8,CD19 T-cells,NK cells,and WBC,RBC,PLT in peripheral blood before and after chemotherapy were significantly different between two groups（ all P〈 0. 05）. Changes in the levels of CD3,CD4,CD8 T-cells,NK cells and WBC,RBC,PLT in peripheral blood after chemotherapy and 6 months after chemotherapy were significantly different between two groups（ all P〈 0. 05）. Conclusion Ubenimex can enhance cellular immune function and reduce myelosuppression for patients with triple-negative breast cancer during chemotherapy.