三阴性乳腺癌患者化疗后回顾性记忆与前瞻性记忆损害的研究

Study of the chemotherapy-induced retrospective and prospective memory impairment of triple-negative breast cancer patients

目的目前有大量研究发现乳腺癌化疗后的记忆障碍存在异质性,是否与分子分型有关目前尚不明确。本研究试图了解三阴性乳腺癌(triple-negative breast cancer,TNBC)和非三阴性乳腺癌(non-triple-negative breast cancer,NTNBC)化疗后的记忆障碍是否存在差异,以及TNBC化疗后的回顾性记忆(retrospective memory,RM)与前瞻性记忆(prospective memory,PM)损害特征。方法以安徽医科大学第二附属医院肿瘤科2014-03-01-2015-06-30的TNBC和NTNBC术后辅助化疗后患者各30例为观察组,同时将年龄、教育程度及体能状况等与观察组相匹配的60名健康女性志愿者为对照组,分别对其进行简易精神状态量表(mini-mental state examination,MMSE)测查及RM和PM问卷调查。结果与健康对照组对比,观察组的MMSE、RM和PM得分分别为(27.08±1.37)、(17.97±4.34)和(18.78±4.24)分,差异均有统计学意义,t值分别为2.880、-6.486和-8.645,均P<0.05;与NTNBC组对比,TNBC组MMSE、RM和PM得分分别为(26.50±1.67)、(19.30±2.60)和(20.33±3.50)分,差异均有统计学意义,t值分别为3.624、-2.483和-3.018,均P<0.05。结论乳腺癌化疗后患者存在不同程度的RM障碍和PM障碍,且TNBC患者的RM和PM损害均较NTNBC患者显著,提示激素受体的不同表达可能与乳腺癌化疗后记忆障碍发生的异质性有关。

OBJECTIVE A large number of studies have found the presence of memory impairment showed hetero- geneity after chemotherapy of breast cancer. But whether it is related to molecular typing is unclear. The objective of this study were to investigate the differences of memory impairment after chemotherapy between triple-negative breast cancer （TNBC） and non-triple-negative breast cancer （NTNBC）,and to understand the characteristics of chemotherapy-induced retrospective （RM） and prospective memory （PM） impairment of TNBC. METHODS Sixty breast cancer patients from the Oncology Department of Second Affiliated Hospital of Anhui Medical University from the March 1, 2014 to June 30, 2015 were taken as the observation group,who had received adjuvant chemotherapy after operation, including 30 cases of TNBC and 30 cases of NTNBC. In addition, 60 cases of healthy women volunteers with matched age and education level were selected as the control group. All participants were administered with mini mental state examination （MMSE）, ret- rospective memory （RM） and prospective memory （PM） questionnaires. RESULTS Compared with the healthy control group, the MMSE, RM and PM scores of observation group were respectively （27.08±1.37） points, （17.97±4. 34） points and （18.78± 4.24） points, and the differences of them were statistically significant （t values were 2. 880, -6. 486 and -8. 645, all P〈0.05）. Compared with the NTNBC group, the MMSE, RM and PM scores of TNBC group were respectively （26.50 ± 1.67） points, （19.30±2. 60） points and （20.33 ± 3.50） points, and the differences of them were statistically significant （t values were 3. 624, -2. 483 and -3. 018, all P〈0.05）. CONCLUSION Patients with breast cancer exist different extents of RM impairment and PM impairment after chemotherapy, and the retrospective and prospective memory damages of patients with TNBC are obviously higher than that in patients with NTNBC, which im- plies that different expressions of hormone receptor may be associated with the occurrence of memory impairment after chemotherapy of breast cancer patients.