白蛋白结合型紫杉醇治疗晚期浸润性小叶癌的疗效及对血清LDH、ALP水平的影响

Effect of albumin binding paclitaxel on serum LDH and ALP in patients with advanced invasive lobular carcinoma

目的探讨白蛋白结合型紫杉醇对晚期浸润性小叶癌(ILC)患者血清乳酸脱氢酶(LDH)以及碱性磷酸酶(ALP)水平的影响。方法前瞻性选取2018年1月至2019年12月于邯郸市中心医院肿瘤科科接受治疗的60例晚期ILC患者,按双盲法分为观察组(n=30)与对照组(n=30)。观察组予以白蛋白结合型紫杉醇+顺铂化疗,对照组予以培美曲塞+顺铂化疗,2组均以21 d为1个疗程,连续治疗3个疗程。比较2组患者的临床疗效,治疗前、治疗3个疗程后血清中期因子(MK)、血小板第4因子(PF4)、LDH以及ALP水平,乳腺癌生存质量量表(FACT-B)评分以及治疗期间不良反应发生情况。结果观察组临床总有效率(40.00%)高于对照组(16.67%),差异有统计学意义(P<0.05)。治疗前,2组患者血清MK、PF4、LDH以及ALP水平比较,差异均无统计学意义(P>0.05);治疗3个疗程后,观察组患者血清MK、PF4、LDH以及ALP水平分别为(0.34±0.32)pg/mL、(0.46±0.17)ng/mL、(81.47±5.16)U/L、(37.52±6.14)U/L,均低于对照组[(2.18±0.96)pg/mL、(2.39±1.02)ng/mL、(123.49±13.25)U/L、(58.19±8.43)U/L],差异均有统计学意义(P<0.001)。治疗前,2组患者FACT-B评分比较,差异无统计学意义(P>0.05);治疗3个疗程后,观察组患者FACT-B评分为(122.96±13.47)分,高于对照组[(110.62±11.03)分],差异有统计学意义(P<0.001)。对照组不良反应发生率为23.33%,观察组不良反应发生率为16.67%,2组不良反应发生率比较,差异无统计学意义(P>0.05)。结论晚期ILC患者采用白蛋白结合型紫杉醇治疗效果确切,可显著改善血清LDH、ALP水平,提升生存质量,值得临床借鉴使用。

Objective To investigate the effect of albumin bound paclitaxel on serum lactate dehydrogenase(LDH)and alkaline phosphatase(ALP)levels in patients with advanced invasive lobular carcinoma(ILC).Methods From January 2018 to December 2019,60 patients with advanced ILC were selected and divided into observation group(n=30)and control group(n=30)according to double-blind method.Patients in the observation group were treated with albumin bound paclitaxel+cisplatin chemotherapy,while patients in the control group were treated with pemetrexed+cisplatin chemotherapy.Both groups were treated with 21 days as a course of treatment for 3 consecutive courses.The clinical efficacy,the changes of serum medium-term factor(MK),platelet factor 4(PF4),LDH and ALP levels,the changes of breast cancer quality of life scale(FACT-B)score and the occurrence of adverse reactions during treatment were compared between the two groups.Results The clinical total effective rate of the observation group(40.00%)was higher than that of the control group(16.67%),the difference was statistically significant(P<0.05);Before treatment,there was no significant difference in serum MK,PF4,LDH and ALP levels between the two groups of patients(P>0.05);after 3 courses of treatment,the observation group's serum MK,PF4,LDH and ALP levels were(0.34±0.32)pg/mL,(0.46±0.17)ng/mL,(81.47±5.16)U/L,(37.52±6.14)U/L,all lower than the control group[(2.18±0.96)pg/mL,(2.39±1.02)ng/mL,(123.49±13.25)U/L,(58.19±8.43)U/L],the differences were statistically significant(P<0.001).Before treatment,the difference in FACT-B score between the two groups was not statistically significant(P>0.05);after 3 courses of treatment,the FACT-B score of the observation group was(122.96±13.47)points,which was higher than the control group[(110.62±11.03)points],the difference was statistically significant(P<0.001).The incidence of adverse reactions in the control group was 23.33%,and the incidence of adverse reactions in the observation group was 16.67%,the difference was not statistically significant(P>0.05).Conclusion Albumin binding paclitaxel is effective in the treatment of patients with advanced ILC,it can significantly improve the serum LDH and ALP levels and improve the quality of life,which is worthy of clinical reference.