Lapatinib靶向治疗乳腺癌HER2阳性伴肺转移患者对肿瘤标志物表达的影响作用

The Effect of Lapatinib Targeting Therapy on the Expression of Tumor Markers in Breast Cancer Lung Metastasis Patients with HER2 Positive

目的探究Lapatinib靶向治疗乳腺癌HER2阳性伴肺转移患者对肿瘤标志物表达的影响作用。方法选取2013年1月至2015年1月期间在恩施土家族苗族自治州中心医院确诊为乳腺癌HER2阳性且伴有肺转移的108例女性患者,根据数字表法随机分为观察组和对照组,每组各54例。对照组采取顺铂联合卡培他滨化疗方案,观察组在对照组的基础上,给予Lapatinib口服治疗。比较两组患者的近期疗效和血清肿瘤标志物的表达水平变化情况以及相应的毒副反应,另通过2年随访,比较两组患者的生存和疾病发展情况。结果观察组治疗有效率和控制率分别是40.74%和61.11%,对照组为22.22%和40.74%,差异有统计学意义(P<0.05)。治疗前,两组患者的血清TPS、CA153、CA125表达水平比较,差异无统计学意义(P>0.05)。治疗后,均显著降低,差异有统计学意义(P<0.05),组间比较显示,观察组肿瘤标志物表达水平改善(降低)程度显著高于对照组,差异有统计学意义(P<0.05)。远期疗效比较显示,观察组的无进展生存时间和中位生存时间分别为6.3±0.5月和12.0±0.8月,对照组分别为3.9±0.3月和8.6±0.7月,观察组显著长于对照组,差异均具有统计学意义(P<0.05),且两组患者的毒副反应均为Ⅰ、Ⅱ级,差异无统计学意义(P>0.05)。结论 Lapatinib在乳腺癌HER2阳性伴肺转移患者治疗中,可以显著的延长患者的生存时间,降低患者血清TPS、CA153、CA125表达水平,且毒副反应低,具有较好的治疗效果。

Objective To investigate the effect of Lapatinib targeting therapy on the expression of tumor markers in breast cancer patients with HER2 positive lung metastasis. Methods 108 female patients diagnosed as breast cancer with HER2 positive and pulmonary metastasis from January 2013 to January 2015,were randomly divided into the experimental group and the control group,with 54 cases in each group. The control group was treated with cisplatin and capecitabine chemotherapy,and the experimental group was given oral administration of Lapatinib on the basis of the control group. The short-term efficacy of the two groups,the changes of the level of serum tumor markers,and the corresponding toxic and side effects were compared. The survival and disease development of the two groups were compared by 2 year follow-up. Results The effective rate and control rate of the experimental group were 40. 74% and 61. 11% respectively,and 22. 22%and 40. 74% respectively in the control group. The difference was significant（P〈0. 05）. Before treatment,the levels of serum TPS,CA153 and CA125 were not significantly different between the two groups（P〈0. 05）. After treatment,the levels of tumor markers in the experimental group were significantly higher than those in the control group（P〈0. 05）. Comparison of long-term efficacy,progression free survival time of the observation group and the median survival time was 6. 3 ± 0. 5 and 12. 0 ± 0. 8 months,the control group were3. 9 ± 0. 3 and 8. 6 ± 0. 7 months,the observation group was significantly longer than the control group,and the differences were statistically significant（P〈0. 05）. The adverse reaction in the two groups were grade I and II,and there was no statistically significant difference（P〈0. 05）. Conclusion Lapatinib in breast cancer patients with positive HER2 patients with pulmonary metastasis,can significantly prolong the survival time of patients and the level of TPS,CA153 and CA125 expression in the serum of patients with decreased,and lowadverse reaction,has a better therapeutic effect.