紫杉醇脂质体联合表柔比星治疗晚期乳腺癌对患者组织中DBC1及SIRT1阳性表达的影响

Effects of paclitaxel liposome combined with epirubicin on the positive expression of DBC1 and SIRT1 in patients with advanced breast cancer

目的探究紫杉醇脂质体联合表柔比星治疗晚期乳腺癌对患者组织中乳腺癌缺失基因1(DBC1)及沉默信息调节因子1(SIRT1)阳性表达的影响,为预后评价提供理论依据。方法选择2014年6月至2016年11月收治的晚期乳腺癌患者74例,使用紫杉醇脂质体联合表柔比星新辅助化疗方案,连续治疗2～6个疗程后使用半定量法对干预前后患者病灶组织切片中DBC1及SIRT1表达及不同病理类型的DBC1及SIRT1表达进行评估,并评判干预后的毒副作用。结果治疗后DBC1及SIRT1表达的阳性率均显著低于治疗前(P<0.05);干预前、干预后乳腺癌不同病理类型组织中的DBC1及SIRT1的阳性指数同期两两比较差异无统计学意义(P>0.05),与同类型干预前比较,干预后DBC1和SIRT1阳性指数得分均明显减少(P<0.05);治疗过程中最常见的毒副作用为骨髓抑制,主要为1/2级中性粒细胞和血小板的减少(或降低),均采取相应的对症治疗后出现好转,没有相关性死亡出现,此外部分患者出现1/2级恶心呕吐或肝功能损伤等。结论脂质体紫杉醇联合表柔比星辅助化疗有助于降低SIRT1和DBC1的阳性表达,安全性高。

Objective To investigate the effect of paclitaxel liposome combined with epirubicin on the positive expression of deleted in breast cancer 1(DBC1)and silent information regulator 1(SIRT1)in patients with advanced breast cancer(ABC),and to provide a theoretical basis for prognosis evaluation.Methods A total of 74 patients with ABC who were admitted to our hospital from June 2014 to November 2016 were treated by paclitaxel liposome combined with epirubicin neoadjuvant chemotherapy.After 2~6 treatment courses,the semi-quantitative method was used to evaluate the expression of DBC1 and SIRT1 in tissue sections of the lesion before and after intervention,and the expression of DBC1 and SIRT1 of different pathological types.In addition,the side effects after intervention were evaluated.Results The positive rates of DBC1 and SIRT1 expression after treatment were significantly lower than those before treatment(P<0.05).No significant difference was found in the positive indexes of DBC1 and SIRT1 of different pathological types of breast cancer before and after intervention(P>0.05).As compared with those of the same type before intervention,positive scores of DBC1 and SIRT1 were significantly reduced after intervention(P<0.05).The most common side effect during treatment was myelosuppression,especially reduction(or decrease)of grade 1/2 neutrophils and platelets,which were improved after symptomatic treatment.No treatment-related death was reported.In addition,some patients had grade 1/2 nausea and vomiting or liver function damage.Conclusion Liposome paclitaxel combined with epirubicin adjuvant chemotherapy can help to reduce the positive expression of SIRT1 and DBC1,and has a higher safety.