鸦胆子油乳联合新辅助化疗治疗局部晚期乳腺癌患者的疗效及对病灶癌基因表达的影响

Curative Effect of Brucea Javanica Oil Emulsion Combined with Neoadjuvant Chemotherapy in the Treatment of Locally Advanced Breast Cancer and Its Effect on the Expression of Malignant Molecules in the Lesion

目的探讨鸦胆子油乳联合新辅助化疗治疗局部晚期乳腺癌患者的疗效及对病灶癌基因表达的影响。方法选取2016年3月至2018年7月于铁岭市中心医院诊断为局部晚期乳腺癌的64例患者作为研究对象,采用随机数字表法分为观察组与对照组,每组32例。观察组接受鸦胆子油乳联合多西他赛、吡柔比星联合环磷酰胺(TAC)方案新辅助化疗,对照组接受TAC方案新辅助化疗,比较两组近期疗效、远期疗效、癌基因表达。结果观察组患者化疗后的有效率59.37%及控制率93.75%,显著高于对照组的34.37%及87.50%,差异有统计学意义(P<0.05);随访2年,观察组无病生存率优于对照组,差异有统计学意义(P<0.05);化疗后,两组乳腺癌病灶中增殖细胞核抗原(PCNA)、Ki-67的m RNA表达水平明显下降,第10号染色体缺失的磷酸酶及张力蛋白同源的基因(PTEN)、半胱氨酸天冬氨酸蛋白酶-3(caspase-3)的m RNA表达水平明显上升,且观察组患者乳腺癌病灶中PCNA、Ki-67的m RNA表达水平明显低于对照组,PTEN、caspase-3的m RNA表达水平明显高于对照组,差异有统计学意义(P<0.05)。结论鸦胆子油乳联合新辅助化疗治疗局部晚期乳腺癌能够改进近期疗效、远期疗效,同时也能调节病灶内癌基因的表达。

Objective To study the efficacy of Brucea javanica oil emulsion combined with neoadjuvant chemotherapy in the treatment of locally advanced breast cancer and its effect on the expression of malignant molecules in the lesion. Methods Patients with locally advanced breast cancer diagnosed in Tieling Central Hospital from March 2016 to July 2018 were randomly assigned into an observation group and a control group, with 32 cases in each group. The observation group received Brucea javanica oil emulsion combined with TAC neoadjuvant chemotherapy and the control group received TAC neoadjuvant chemotherapy. The short-term efficacy, long-term efficacy, and oncogene expression were compared between the 2 groups. Results The effective rate of observation group were 59.37% and 93.75% after chemotherapy, which were significantly higher than 34.37% and 87.50% of the control group, the difference was statistically significant(P<0.05). In the following 2 years, the disease-free survival rate of the observation group was better than that of the control group, and the difference was statistically significant(P<0.05). After chemotherapy, the expression levels of PCNA and Ki-67 in breast cancer lesions of the 2 groups were significantly decreased, the mRNA expression levels of phosphatase and tensin homologous genes(PTEN) and caspase-3(caspase-3) deleted on chromosome 10 increased significantly, and the m RNA expression levels of PCNA and ki-67 of breast cancer lesions in the observation group were significantly lower than those of the control group, and the mRNA expression levels of PTEN and caspase-3 were significantly higher than those of the control group. The difference was statistically significant(P<0.05). Conclusion Brucea javanica oil emulsion combined with neoadjuvant chemotherapy for locally advanced breast cancer can improve the short-term and long-term efficacy, and also can regulate the expression of malignant molecules in the lesion.