摘要
目的观察曲妥珠单抗联合吡咯替尼治疗人表皮生长因子受体-2(HER-2)阳性乳腺癌的效果及对肿瘤标志物水平的影响。方法回顾性选取2020年6月—2022年7月龙岩市第一医院收治的HER-2阳性乳腺癌患者90例,根据治疗方式不同分为联合单抗组(n=55)和吡咯替尼组(n=35)。吡咯替尼组采用吡咯替尼治疗,联合单抗组采用曲妥珠单抗联合吡咯替尼治疗,21 d为1个疗程,2组均持续治疗4个疗程。比较2组近期疗效,治疗前后血清相关指标[干扰素-γ、白介素-10(IL-10)、胸苷激酶1(TK-1)、肿瘤坏死因子-α(TNF-α)]、血清肿瘤标志物[癌胚抗原(CEA)、糖类抗原153(CA153)、糖类抗原125(CA125)]水平、生活质量评分量表(QOL)评分及不良反应。结果联合单抗组客观缓解率为60.00%,高于吡咯替尼组的37.14%(χ^(2)=4.472,P=0.034)。与治疗前比较,治疗4个疗程后,2组干扰素-γ、TK-1、TNF-α水平降低,且联合单抗组TK-1、TNF-α水平低于吡咯替尼组,但干扰素-γ水平高于吡咯替尼组(P<0.01),2组IL-10水平组内、组间比较差异均不显著(P>0.05);2组CEA、CA153、CA125水平降低,且联合单抗组低于吡咯替尼组(P<0.01);2组QOL评分升高,且联合单抗组高于吡咯替尼组(P<0.01)。联合单抗组与吡咯替尼组不良反应总发生率比较差异不显著(34.55%vs.31.43%,χ^(2)=0.094,P=0.760)。结论曲妥珠单抗联合吡咯替尼治疗HER-2阳性乳腺癌可发挥较好效果,显著降低患者血清肿瘤标志物水平,抑制炎性反应,维持免疫功能平衡,且不良反应无明显增加。
Objective To observe the effect of trastuzumab combined with pyrroltinib in the treatment of HER-2 positive breast cancer and its influence on the level of tumor markers.Methods A total of 90 patients with HER-2 positive breast cancer admitted to Longyan First Hospital from June 2020 to July 2022 were retrospectively selected and divided into the combined monoclonal antibody group(n=55)and the pyrroltinib group(n=35)according to different treatment methods.The pyrroltinib group was treated with pyrroltinib,and the combined monoclonal antibody group was treated with trastuzumab combined with pyrroltinib.Twenty-one days was a course of treatment,and both groups were treated for 4 courses.The short-term efficacy,serum related indicators(interferon-γ,IL-10,TK-1,TNF-α),serum tumor markers(CEA,CA153,CA125)levels,quality of life rating scale(QOL)scores before and after treatment,and adverse reactions were compared between the two groups.Results The objective remission rate of the combined monoclonal antibody group was 60.00%,which was higher than 37.14%in the pyrroltinib group(χ^(2)=4.472,P=0.034).Compared with pre-treatment,after 4 courses of treatment,the levels of interferon-γ,TK-1 and TNF-αin the two groups were decreased,and the levels of TK-1 and TNF-αin the combined monoclonal antibody group were lower than those in the pyrroltinib group,but the level of interferon-γwas higher than that in the pyrroltinib group(P<0.01).There was no significant difference in the level of IL-10 between the two groups(P>0.05).The levels of CEA,CA153 and CA125 in the two groups were decreased,and those in the combined monoclonal antibody group were lower than those in the pyrroltinib group(P<0.01).The QOL score of the two groups increased,and the combined monoclonal antibody group was higher than that of the pyrroltinib group(P<0.01).There was no significant difference in the total incidence of adverse reactions between the combined monoclonal antibody group and the pyrroltinib group(34.55%vs.31.43%,χ^(2)=0.094,P=0.760).Conclusion Trastuzumab combined with pyrroltinib in the treatment of HER-2 positive breast cancer can play a good effect,significantly reduce the level of serum tumor markers,inhibit inflammatory reaction,maintain the balance of immune function,and there is no significant increase in adverse reactions.
作者
涂兴峰
黎鹏飞
李蒙玲
TU Xingfeng;LI Pengfei;LI Mengling(Thyroid and Breast Surgical Department,Longyan First Hospital,Fujian Province,Longyan 364000,China)
出处
《临床合理用药杂志》
2024年第29期23-26,共4页
Chinese Journal of Clinical Rational Drug Use
作者简介
通信作者:李蒙玲,E-mail:809188404@qq.com。
