脾多肽联合新辅助化疗对局部晚期乳腺癌临床疗效观察

Clinical efficacy of lienal polypeptide in adjuvant chemotherapy of locally advanced breast cancer

目的研究脾多肽联合新辅助化疗对局部晚期乳腺癌术后免疫功能、近期疗效及生活质量的影响。方法收集2017年1月至2018年12月在河南大学第一附属医院诊断为局部晚期浸润性乳腺癌87例女性患者临床资料,所有患者均给予新辅助化疗,观察组接受TEC(多西他赛、表柔比星、环磷酰胺)化疗方案联合脾多肽注射液辅助治疗,对照组患者仅接受TEC方案化疗,治疗第9周评价近期疗效及安全性,对外周血T淋巴细胞亚群进行分析,并评估患者生活质量(KPS评分)。结果观察组谷草转氨酶(AST)、谷丙转氨酶(ALT)、谷氨酰转肽酶(GGT)、肌酐(Cr)、尿素氮(BUN)水平与对照组比较,差异均无统计学意义(P>0.05),观察组治疗后疾病控制率和总有效率略高于对照组,但差异无统计学意义(P>0.05)。观察组CD3^+、CD4^+T淋巴细胞及CD4^+/CD8^+比值高于对照组(P<0.05),CD8^+T淋巴细胞低于对照组(P<0.05),观察组KPS评分及生活质量优于对照组(P<0.05),差异均有统计学意义。结论脾多肽辅助TEC方案化疗能够有效提高局部晚期乳腺癌患者免疫功能,改善患者生活质量。

【Objective】To investigate the clinical efficacy of Lienal Polypeptide Injection combined with chemotherapy on locally advanced breast cancer and observe its effect on the immune function and life quality.【Methods】From January 2017 to December 2018,in the First Affiliated Hospital of Henan University,87 locally advanced breast cancer patients were selected,and they were allocated in control group or study group by whether lienal polypeptide adjuvant chemotherapy was administered,the study group was treated with TEC chemotherapy combined with lienal polypeptide adjuvant therapy,and the control group was treated with TEC chemotherapy alone.After chemotherapy,liver and renal function,the recent curative effect,the peripheral blood T lymphocyte subsets and KPS score in the two groups were compared.【Results】After chemotherapy,the recent curative effect,total effective rate and disease control rate in the observation group were slightly higher than those in the control group,but the differences were not statistically significant(P>0.05).The number of CD3^+,CD4^+ T cells and the ratio of CD4^+/CD8^+ T cells in the observation group were higher than those in the control group,the differences were statistically significant(P<0.05);the number of CD8^+T cells was lower,the difference was statistically significant(P<0.05).Compared with the control group,the KPS score and quality of life improvement of the observation group were higher after chemotherapy,the differences were statistically significant(P<0.05).There was no significant difference between the two groups in levels of serum ALT,AST,GGT,Cr or BUN(P>0.05).【Conclusion】The regimen of lienal polypeptide combined with TEC chemotherapy can effectively reduce the load of locally advanced breast cancer,enhance the humoral immunity and cellular immune response.