曲妥珠单抗联合紫杉醇脂质体及卡培他滨对HER-2阳性复发转移性乳腺癌患者血清LCN-2及Six1表达的影响

Effect of herceptin combined with paclitaxel liposome and capecitabine on the expression of serum LCN-2 and Sixl in patients with HER-2 positive recurrence-metastasis breast cancer

目的:探讨曲妥珠单抗联合紫杉醇脂质体及卡培他滨(HPX联合方案)对于人表皮生长因子-2 (human epidermal growth factor-2, HER-2)阳性复发性转移乳腺癌患者血清脂质运载蛋白-2 (lipocalin-2,LCN-2)及Sixl (sine oculis homeobox homolog 1)表达的影响。方法:将2012年1月至2015年12月间马鞍山市人民医院收治的HER-2阳性复发转移性乳腺癌患者100例作为研究对象,随机分为观察组和对照组。观察组患者采用HPX方案进行治疗,对照组患者采用紫杉醇脂质体及卡培他滨(PX方案)进行治疗,对比治疗前后2组患者临床疗效、血清LCN-2与Sixl的表达水平,记录住院治疗期间不良反应发生率,随访1年中2组患者的生存率和生活质量。结果:观察组治疗的总有效率(78%)较对照组(58%)高,差异有统计学意义(P<0.05);治疗后,2组患者血清LCN-2和Sixl均下降,观察组患者血清LCN-2明显低于对照组[(76.22±10.25) ng·mL～(-1)vs (86.36±10.85) ng·mL～(-1),P<0.05],血清Six1明显低于对照组[(4.95±0.43) ng·mL～(-1)vs (5.39±0.61) ng·mL～(-1),P<0.05]; 2组患者不良反应发生率相似;随访1年,观察组、对照组患者的生存率分别为90%和86%,差异无统计学意义(P>0.05),观察组患者生活质量高于对照组(P<0.05)。结论:HPX联合方案可降低HER-2阳性复发性乳腺癌患者血清LCN-2及Six1表达水平,抑制肿瘤细胞的增殖分裂,安全可靠。

Objective To investigate the influence of herceptin combined with paclitaxel liposome and capecitabine（HPX combination scheme） on serum LCN-2 and six1 in patients with HER-2 positive recurrence-metastasis breast cancer.Methods From January 2012 to December 2015,100 cases of patients with HER-2 positive recurrence-metastasis breast cancer were randomly divided into the observation group and the control group.Patients in the observation group were treated with HPX combination scheme,while the control group were treated with paclitaxel liposome and capecitabine（PX scheme）.The clinical efficacy,expression level of serum LCN-2 and Six1 were compared before and after treatment,and the adverse reaction rate was recorded during the hospital-stay time.The survival rate and quality of life were compared within 1 year after discharge.Results The total effective rate of the observation group was 78%,higher than that of the control group（58%）,and the difference was statistically significant（ P〈0.05）; after treatment,the serum LCN-2 and Six1 decreased in both of the two groups,the serum level of LCN-2 in the observation group were significantly lower than those in the control group [（76.22±10.25） ng？mL-1 vs（86.36±10.85） ng？mL-1,P〈0.05],and the serum levels of Six1 were significantly lower than those in the control group [（4.95±0.43）ng？mL-1 vs（5.39±0.61） ng？mL-1,P〈0.05）].The incidence of adverse reactions in the two groups was similar.During the one year follow up,the survival rates of the observation group and the control group were 90% and 86% respectively（ P〉0.05）,the quality of life in the observation group was higher than that in the control group（ P〈0.05）. Conclusion HPX combination scheme is safe and reliable,can reduce the expression of serum LCN-2 and Six1 in patients with HER-2 positive recurrent breast cancer,depressing the proliferation and division of tumor cells.