吡咯替尼联合多西他赛治疗HER2阳性晚期乳腺癌患者的效果及对T淋巴细胞亚群水平的影响

Effect of Pyrrolotinib Combined with Docetaxel in the Treatment of Patients with HER2 Positive Advanced Breast Cancer and Its Effect on the Level of T Lymphocyte Subsets

目的:探讨吡咯替尼联合多西他赛治疗人表皮生长因子受体2(HER2)阳性晚期乳腺癌患者的效果及对T淋巴细胞亚群水平的影响。方法:选取2020年6月-2021年12月上饶市人民医院80例HER2阳性晚期乳腺癌患者作为研究对象,采用随机数字表法分为对照组(40例,接受多西他赛治疗)与研究组(40例,接受吡咯替尼联合多西他赛治疗)。比较两组治疗前后的糖类抗原125(CA125)、血管内皮生长因子(VEGF)、T淋巴细胞亚群(CD8^(+)、CD4^(+)和CD4^(+)/CD8^(+))、癌胚抗原(CEA)水平、临床疗效及药物不良反应。结果:治疗前两组的CA125、CD8^(+)、VEGF、CD4^(+)、CEA、CD4^(+)/CD8^(+)水平比较,差异均无统计学意义(P>0.05);治疗后研究组的VEGF、CEA、CA125、CD8^(+)水平均低于对照组,CD4^(+)、CD4^(+)/CD8^(+)水平均高于对照组,研究组的ORR(85.00%)、DCR(97.50%)均高于对照组(60.00%、82.50%),以上差异均有统计学意义(P<0.05)。两组的总不良反应发生率(研究组25.00%vs对照组20.00%)比较,差异无统计学意义(P>0.05)。结论:吡咯替尼联合多西他赛治疗HER2阳性晚期乳腺癌患者可有效改善T淋巴细胞亚群及肿瘤标志物表达水平,提高患者实体瘤疗效。

Objective:To investigate the effect of Pyrrolotinib combined with Docetaxel in the treatment of patients with HER2 positive advanced breast cancer and its effect on the level of T lymphocyte subsets.Method:A total of 80 patients with HER2 positive advanced breast cancer in Shangrao People’s Hospital from June 2020 to December 2021 were selected as the subjects.They were randomly divided into control group(40 cases,receiving Docetaxel)and study group(40 cases,receiving Pyrrolidine combined with Docetaxel).The levels of carbohydrate antigen 125(CA125),vascular endothelial growth factor(VEGF),T lymphocyte subsets(CD8+,CD4+and CD4+/CD8+),carcinoembryonic antigen(CEA)before and after treatment,clinical efficacy and adverse drug reactions were compared between the two groups.Result:There were no significant differences in the levels of CA125,CD8+,VEGF,CD4+,CEA and CD4+/CD8+between the two groups before treatment(P>0.05);after treatment,the levels of VEGF,CEA,CA125,CD8+in the study group were lower than those in the control group,and the levels of CD4+,CD4+/CD8+were higher than those in the control group,the ORR(85.00%)and DCR(97.50%)of the study group were higher than those of the control group(60.00%and 82.50%),the above differences were statistically significant(P<0.05).There was no significant difference in the total incidence of adverse reactions between the two groups(25.00%in the study group vs.20.00%in the control group)(P>0.05).Conclusion:Pyrrolidone combined with Docetaxel can effectively improve the expression of T lymphocyte subsets and tumor markers in patients with HER2 positive advanced breast cancer,and improve the curative effect of solid tumors.