曲妥珠单抗联合多西他赛对HER-2阳性中晚期乳腺癌患者血清肿瘤标志物及免疫功能的影响

Effects of trastuzumab combined with docetaxel on serum tumor markers and immune function in patients with HER-2 positive breast cancer

目的探讨曲妥珠单抗联合多西他赛对人表皮生长因子受体-2(HER-2)阳性中晚期乳腺癌患者血清癌胚抗原(CEA)、糖类抗原153(CA153)、组织多肽特异抗原(TPS)及免疫功能的影响。方法选取2016年8月至2018年9月间陕西省安康市人民医院收治的96例HER-2阳性中晚期乳腺癌患者,采用随机数表法分为观察组和对照组,每组48例。对照组患者采用多西他赛化疗治疗,观察组患者在对照组治疗基础上采用曲妥珠单抗治疗,比较两组患者的血清肿瘤标志物和免疫功能。结果观察组患者总有效率为79.2%,高于对照组的52.1%,差异有统计学意义(P<0.05)。两组患者治疗期间的不良反应主要为消化道反应、血液系统反应、肝肾功能异常和皮肤反应等,多为1~2级,组间对比,差异无统计学意义(P>0.05)。观察组患者治疗后的血清CEA、CA153和TPS含量低于对照组(P<0.05)。两组患者治疗后的CD3^+与CD4^+值均高于治疗前,且观察组高于对照组,差异均有统计学意义(均P<0.05)。两组患者治疗前后CD8^+值比较,差异无统计学意义(P>0.05)。结论曲妥珠单抗联合多西他赛治疗HER-2阳性中晚期乳腺癌患者,能降低血清CEA、CA153和TPS含量,改善患者的免疫功能,提高治疗效果,安全性较好。

Objective To investigate the effects of trastuzumab combined with docetaxel on serum carcino-embryonic antigen(CEA),carbohydrate antigen-153(CA153),tissue polypeptide specific antigen(TPS)and immune function in patients with advanced human epidermal growth factor receptor-2(HER-2)-positive breast cancer.Methods From August 2016 to September 2018,96 patients with HER-2 positive advanced breast cancer treated at Ankang People’s Hospital were selected.According to the random number table method,they were divided into an observation group and a control group with 48 patients in each group.The observation group was given trastuzumab combined with docetaxel and the control group was only given chemotherapy based on docetaxel.Both groups were treated for 4 cycles.Changes in serum tumor markers and immune function were recored.Results The overall efficacy rate was 79.2%in the observation group,which was significantly higher than 52.1%of the control group(P<0.05).The adverse reactions during the two groups mainly included digestive tract reaction,blood system reaction,liver and kidney dysfunction,and skin reaction,etc,most of which were 1 to 2 grades(P>0.05).The levels of serum CEA,CA153 and TPS were significantly lower in the observation group than in the control group after treatment(all P<0.05).The CD3^+and CD4^+values significantly higher in the two groups after treatment were than those before the treatment(all P<0.05)with the observation group also significantly higher than the control group(all P<0.05).There was no significant difference in the CD8^+values compared between the two groups before and after the treatment(P>0.05).Conclusion The combination of trastuzumab and docetaxel can reduce serum CEA,CA153 and TPS levels,improve the immune function of patients,and improve the therapeutic efficacy with good safety in patients with HER-2 positive middle and advanced breast cancer.