吉西他滨联合顺铂对Ⅲ期乳腺癌患者ER、MMP-9及雌激素影响研究

Effect of gemcitabine combined with cisplatin on ER,MMP-9 and estrogen in patients with stage III breast cancer

目的探究吉西他滨联合顺铂对Ⅲ期乳腺癌患者雌激素受体（estrogen receptor,ER）、基质金属蛋白酶（matrix metalloprotein,MMP）及雌激素影响。方法收集辽宁医学院附属第一医院肿瘤科收治的乳腺癌患者93例,根据随机对照表分为对照组和试验组。2组患者均实施乳腺癌手术,术后对照组采用顺铂化疗方案,第一天静脉滴注顺铂90 mg/m2,21 d为1个疗程,连续用药6个疗程;试验组采用顺铂联合吉西他滨化疗,第1天和第8天静脉滴注1000 mg/m2吉西他滨,第3~5天静脉滴注顺铂90 mg/m2,每28天为1个周期,连续用药2周期,治疗结束后对比分析2组临床疗效及雌激素受体（estrogen receptor,ER）、MMP-9、雌激素水平、不良反应发生率。结果与治疗前比较,治疗后2组患者血清ER、MMP-9、雌酮（estrone,E1）、雌二醇（estradiol,E2）水平降低（P〈0.05）,FSH、LH水平升高（P〈0.05）;与对照组治疗后比较,试验组患者的血清ER、MMP-9、E1、E2水平较低（P〈0.05）,FSH、LH水平较高（P〈0.05）;试验组不良反应发生率为6.38%,对照组为15.22%,2组不良反应发生率比较差异无统计学意义。结论吉西他滨联合顺铂对Ⅲ期乳腺癌患者疗效显著,可改善临床症状,并能显著降低患者血清ER、MMP-9、E1、E2水平、提高FSH、LH水平。

Objective To explore the effect of gemcitabine combined with cisplatin on ER,MMP-9 and estrogen in patients with stage III breast cancer. Methods 93 patients with breast cancer were collected and randomly divided into control group and experimental group. Two groups were all under breast cancer surgery,control group was treated with cisplatin chemotherapy,1st day of intravenous infusion of cisplatin 90 mg / m2,21 days for a course of treatment,continuous treatment of 6 courses. Experimental group were treated with cisplatin combined with gemcitabine chemotherapy,1st and8 th days of intravenous infusion of 1000 mg / m2 gemcitabine,3 ~ 5d,intravenous drip of cisplatin 90 mg / m2,every 28 days a cycle,continuous administration of 2 cycles,After treatment,the clinical efficacy of the two groups,the level of ER,MMP-9,estrogen and the incidence of adverse reactions were compared. Results Compared with before treatment,the levels of serum MMP-9,E1,E2,ER were decreased（ P〈0. 05）,and the level of LH and FSH were increased（ P〈0. 05） of two group post-treatment. Compared with control group post-treatment,the levels of serum ER,MMP-9,E1,E2 were lower in experimental group（ P〈0. 05）,and the LH and FSH levels were higher（ P〈0. 05）. The incidence of adverse reactions of experimental group was 6. 38%,and control group was 15. 22%,the incidence of adverse reactions in the two groups was no significant difference.Conclusion Gemcitabine combined with cisplatin in the treatment of patients with breast cancer has a significant effect,and can improve the clinical symptoms,reduce the serum ER,E1,MMP-9,E2 levels,improve FSH,LH level.