曲妥珠单抗联合多西他赛化疗对HER2阳性晚期乳腺癌患者血清铁蛋白、IL-6、IL-8、IL-10表达及甲状腺功能的影响

Effect of trastuzumab combined with docetaxel chemotherapy on serum ferritin,IL-6,IL-8,IL-10 expressions and thyroid function in patients with HER2-positive advanced breast cancer

目的探讨曲妥珠单抗联合多西他赛化疗对人表皮生长因子受体2(HER2)阳性晚期乳腺癌(ABC)患者血清铁蛋白,IL-6,IL-8,IL-10表达及甲状腺功能的影响。方法选取2017年1月-2018年1月收治的84例HER2阳性ABC患者,根据治疗方案分为对照组(多西他赛治疗)和联合组(曲妥珠单抗联合多西他赛治疗)。对比2组治疗前后血清铁蛋白、IL-6、IL-8、IL-10水平及甲状腺功能指标:三碘甲腺原氨酸(T3)、四碘甲腺原氨酸(T4)、游离T3(FT3)、游离T4(FT4)和促甲状腺激素(TSH)。对比2组临床疗效及随访1年复发情况,并统计治疗及随访1年期间不良反应发生情况。结果治疗后,2组血清铁蛋白、IL-6、IL-8、IL-10水平均低于治疗前(P<0.05),且联合组低于对照组(P<0.05);2组甲状腺功能指标T3、T4、FT3、FT4和TSH,不管是治疗前后同组比较还是组间比较,差异均无统计学意义(P>0.05);联合组治疗总有效率高于对照组(61.90%vs 38.10%,P<0.05),复发率低于对照组(9.76%vs 27.50%,P<0.05);2组LVEF降低、窦性心动过速、骨髓抑制等不良反应发生率经比较,差异均无统计学意义(P>0.05)。结论曲妥珠单抗联合多西他赛化疗有助于抑制HER2阳性ABC患者血清铁蛋白、IL-6、IL-8和IL-10表达,对甲状腺功能影响小,临床疗效显著,复发率低,安全可靠。

AIM To investigate the effect of trastuzumab combined with docetaxel chemotherapy on expre-ssions of serum ferritin,IL-6,IL-8,IL-10 and thyroid function in patients with human epidermal growth factor receptor 2(HER2)positive advanced breast cancer(ABC).METHODS A total of 84 patients with HER2-positive ABC admitted from January 2017 to January 2018 were randomly divided into control group(docetaxel treatment)and combined group(trastuzumab combined with docetaxel treatment)according to the treatment plan.Se-rum ferritin,IL-6,IL-8,IL-10 levels and thyroid function indexes:triiodothyronine(T3),tetraiodothyronine(T4),free T3(FT3),free T4(FT4)and thyroid stimulating hormone(TSH)before and after treatment were compared between the 2 groups.The clinical efficacy and recurrence in 1 year follow-up of 2 groups were compared,and the incidence of adverse reactions during treatment and 1 year follow-up was counted.RESULTS After treatment,the levels of serum ferritin,IL-6,IL-8 and IL-10 in the 2 groups were lower than those before treatment(P<0.05),and the combined group was lower than the control group(P<0.05).There were no significant differences in thyroid function indexes T3,T4,FT3,FT4 and TSH between the same group before and after treatment or between the 2 groups(P>0.05).The total effective rate of treatment in the combined group was higher than that in the control group(61.90%vs 38.10%,P<0.05),and the recurrence rate in the combined group was lower than that in the control group(9.76%vs 27.50%,P<0.05).There were no significant differences in the incidences of adverse reactions such as decreased left ventricular ejection fraction(LVEF),sinus tachycardia and bone marrow suppression,etc.between the 2 groups(P>0.05).CONCLUSION Trastuzumab combined with docetaxel chemotherapy can inhibit the expression of serum ferritin,IL-6,IL-8 and IL-10 in HER2-positive ABC patients.It has little effect on thyroid function,significant clinical efficacy,low recurrence rate,safety and reliability.