注射用曲妥珠单抗对局部晚期乳腺癌患者的疗效及相关指标的影响

Clinical efficacy of trastuzumab for injection on locally advanced breast cancer and related indexes

目的 探讨注射用曲妥珠单抗对局部晚期乳腺癌患者的疗效及相关指标的影响。方法 选取宁波市疗效中心李惠利东部医院肿瘤科收治的局部晚期乳腺癌患者166例,按随机数字表法分组,对照组83例予以术前新辅助化疗,研究组83例在对照组基础上予以注射用曲妥珠单抗治疗,检查记录2组间血清肿瘤标志物水平、肿瘤细胞凋亡指数及增殖活性、Bcl-2、Bax基因表达水平,同时比较临床疗效及不良反应发生率。结果 治疗后,对照组总缓解率（78.32%）低于研究组（90.36%）,研究组总糖类抗原CA125、癌胚抗原（CEA）、恶性肿瘤特异性生长因子（tumor specific growth factor,TSGF）水平较对照组低,肿瘤组织凋亡指数（apoptosis index,AI）水平较对照组高,S期细胞比率（S-phase fraction,SPF）、细胞增殖指数（PI）水平较对照组低,治疗后肿瘤组织Bcl-2基因表达水平较对照组低,Bax基因表达水平较对照组高,2组比较差异均有统计学意义（P〈0.05）;2组患者不良反应差异无统计学意义。结论 注射用曲妥珠单抗能够明显提高局部晚期乳腺癌患者总缓解率,降低血清肿瘤标志物水平,能够下调凋亡相关基因Bcl-2的表达,上调Bax基因表达,促进肿瘤细胞凋亡。

Objective To investigate the effect of trastuzumab for injection on apoptosis and the expression of related genes in locally advanced breast cancer and related indexes.Methods 166 patients with locally advanced breast cancer were selected and divided into two groups, 83 cases in the control group treated with neoadjuvant chemotherapy before operation, 83 cases in the experimental group received trastuzumab for injection on the basis of the control group, serum tumor marker levels, tumor cell apoptosis index and proliferation activity, Bcl-2, Bax gene expression levels, the clinical effect and incidence of adverse reactions were compared after the treatment.Results The effective rate in the control group（78.32%）was lower than the experimental group（90.36%）, with significant difference （P〈0.05）.Compared with the control group, serum levels of CA153,CA125,CEA,TSGF were lower in the experimental group after chemotherapy, levels of apoptosis index（AI） in tumor tissue was higher, levels of S-phase fraction （SPF）, proliferation index （ PI） were lower after treatment, Bcl-2 gene in tumor tissue expression level was lower, Bax gene expression level was higher after treatment, all with significant difference （P〈0.05）.There was no significant difference in the incidence of adverse reactions between two groups. Conclusion The trastuzumab for injection treatment can significantly improve the total remission rate of patients with locally advanced breast cancer , reduce the levels of serum tumor markers, can down-regulate the expression of apoptosis related gene Bcl-2, up-regulate the expression of Bax gene, promote the apoptosis of tumor cells.