白蛋白结合型紫杉醇联合AP方案在浸润性小叶癌中的应用及其对FCN3、sRAGE和nectin-4的影响

Application of albumin-bound paclitaxel combined with AP regimen in invasive lobular carcinoma and its effect on FCN3, sRAGE and nectin-4

目的 探讨白蛋白结合型紫杉醇联合AP方案在浸润性小叶癌中的应用及其对纤维胶凝蛋白3(FCN3)、可溶性晚期糖基化终末产物受体(sRAGE)、结合素-4(nectin-4)的影响。方法 前瞻性收集2017—2020年在邯郸市中心医院、河北医科大学第四医院就诊的200例晚期乳腺浸润性小叶癌患者临床资料,以数字表法将其分成对照组和观察组各100例,对照组采用AP方案治疗,观察组采用白蛋白结合型紫杉醇联合AP方案治疗,对比两组患者的疗效、生存质量、不良反应、FCN3、sRAGE和nectin-4水平,同时分析患者血清FCN3、sRAGE和nectin-4水平和临床不同病理特征之间的联系。结果 观察组的临床疗效显著高于对照组(P<0.05);观察组的生活质量评分显著高于对照组(P<0.05);观察组不良反应发生率显著低于对照组(P<0.05);治疗前两组的FCN3、sRAGE和nectin-4水平均差异无统计学意义(P>0.05),治疗后观察组的FCN3、sRAGE和nectin-4水平显著优于对照组(P<0.05);不同年龄、病理类型、肿瘤直径、孕激素受体表达、增殖细胞核抗原表达及雌激素受体表达等与患者血清FCN3、sRAGE和nectin-4的表达相比,差异无统计学意义(P>0.05),而不同TNM分期和淋巴结是否转移与血清FCN3、sRAGE和nectin-4的表达相比,差异有统计学意义(P<0.05)。结论 白蛋白结合型紫杉醇联合AP方案治疗浸润性小叶癌,疗效确切,能提高患者生存质量,不良反应少,改善血清因子及预后,值得在临床上推广应用。

ObjectiveTo evaluate the application of albumin-bound paclitaxel combined with AP regimen in invasive lobular carcinoma and its effect on fibronectin-3(FCN3),soluble advanced glycation end products receptor(sRAGE),and nectin-4.Methods The clinical data of 200 patients with advanced invasive lobular carcinoma of the breast who were treated in Handan Central Hospital and the Fourth Hospital of Hebei Medical University from 2017 to 2020 were prospectively collected,and divided into control group and observation group by number table.The control group was treated with AP regimen and the observation group was treated with albumin-bound paclitaxel combined with AP regimen.The efficacy,quality of life,adverse reactions,FCN3,sRAGE and nectin-4 levels of the two groups were compared.The correlations between the levels of serum FCN3,sRAGE and nectin-4 in patients with different clinical pathological characteristics were analyzed.Results The clinical efficacy of the observation group was significantly higher than that of the control group(P<0.05).The quality of life score of the observation group was significantly higher than that of the control group(P<0.05).The incidence of adverse reactions in the observation group was significantly lower than that of the control group(P<0.05).The levels of FCN3,sRAGE and nectin-4 in the two groups before treatment were not significantly different(P>0.05).After treatment,the levels of FCN3,sRAGE and nectin-4 in the observation group were significantly better than those in the control group(P<0.05).There was no significant difference in expression of serum FCN3,sRAGE or nectin-4,among patients with different age,pathological type,tumor diameter,progesterone receptor expression,proliferating cell nuclear antigen expression,or estrogen receptor expression(P>0.05).There were significant differences in the expression of serum FCN3,sRAGE and nectin-4 among patients with different TNM stages,and lymph node metastasis(P<0.05).Conclusion The combination therapy of albumin-bound paclitaxel with the AP regimen for the treatment of invasive lobular carcinoma has demonstrated precise efficacy,contributing to an improved quality of life for patients.This approach exhibits few adverse reactions,enhances serum factors,and positively influences prognosis.Therefore,it is worthy of widespread clinical application.