摘要
目的探讨曲妥珠单抗联合阿贝西利治疗晚期人表皮生长因子受体2(Her-2)阳性乳腺癌患者的临床疗效及对肿瘤标志物和免疫功能的影响。方法选取2022年6月至2024年6月嘉兴大学附属第二医院收治的晚期Her-2阳性乳腺癌患者120例,根据随机数表法分为试验组(60例)和参照组(60例),参照组予以阿贝西利治疗,试验组患者在参照组的基础上予以曲妥珠单抗进行联合治疗,比较两组患者临床疗效,并比较两组治疗前后肿瘤标志物、免疫功能和血脂指标水平,观察两组患者不良反应发生情况。计数资料采取例或%表示,采用χ^(2)检验,组间计量资料采用独立样本t检验,组内比较采用配对t检验。结果试验组治疗总有效率高于参照组[88.33%(53/60)比68.33%(41/60),χ^(2)=7.070,P<0.05];试验组治疗完全缓解率和病情稳定率高于参照组[43.33%(26/60)比20.00%(12/60)、31.67%(19/60)比11.67%(7/60),χ^(2)=6.315、5.739,P<0.05]。治疗后试验组患者糖类抗原15-3(CA153)、癌胚抗原(CEA)和糖类抗原125(CA125)水平低于参照组[(30.01±3.32)U/ml比(38.19±4.47)U/ml、(4.28±0.43)ng/ml比(6.07±0.69)ng/ml、(31.62±3.37)U/ml比(35.74±3.60)U/ml,t=11.393、16.892、6.443,P<0.01]。治疗后试验组患者群集分化抗原3^(+)(CD3^(+))和群集分化抗原4^(+)(CD4^(+))水平高于参照组(60.90±5.19比55.19±4.47和38.10±3.60比34.06±3.23,t=6.453和6.455,P<0.01);治疗后试验组患者群集分化抗原8^(+)(CD8^(+))水平低于参照组(27.39±2.96比31.72±3.19,t=7.696,P<0.01)。治疗后试验组患者总胆固醇(TC)、甘油三酯(TG)和低密度脂蛋白胆固醇(LDL-C)水平低于参照组[(4.01±0.36)mmol/L比(4.69±0.53)mmol/L、(1.06±0.12)mmol/L比(1.36±0.14)mmol/L、(2.02±0.17)mmol/L比(2.32±0.22)mmol/L,t=8.134、12.156、8.565,P<0.01];治疗后试验组患者高密度脂蛋白胆固醇(HDL-C)水平高于参照组[(2.52±0.21)mmol/L比(1.85±0.19 mmol/L,t=18.319,P<0.01]。结论曲妥珠单抗联合阿贝西利治疗晚期Her-2阳性乳腺癌患者的临床疗效显著,可明显改善患者肿瘤标志物水平,提高免疫功能和血脂水平,安全性较高。
Objective To investigate the clinical efficacy of trastuzumab combined with arbesilide in the treatment of advanced human epidermal growth factor receptor-2(Her-2)positive breast cancer patients and the impact on tumor markers and immune function.Methods Totally,120 patients with advanced Her-2 positive breast cancer admitted to the Second Affiliated Hospital of Jiaxing University from June 2022 to June 2024 were selected and divided into test group(60 cases)and control group(60 cases)according to the random number table.The control group was treated with Abexili,and the experimental group received combination therapy with trastuzumab on the basis of the control group.The clinical efficacy,the levels of tumor markers,immune function,and blood lipid indicators before and after treatment were compared between two groups.The occurrence of adverse reactions was observed in the two groups.The count data were represented by n or%,and the chi square test was used.Independent sample t-test was used for inter group measurement data,and paired t-test was used for intra group comparison.Results The total effective rate of the experimental group was significantly higher than that of the control group[88.33%(53/60)vs.68.33%(41/60),χ^(2)=7.070,P<0.05].The complete remission rate and disease stability rate of the experimental group were significantly higher than those of the control group[43.33%(26/60)vs.20.00%(12/60)and 31.67%(19/60)vs.11.67%(7/60),χ^(2)=6.315,5.739,P<0.05].After treatment,the levels of carbohydrate antigen 15-3(CA153),carcinoembryonic antigen(CEA),and cancer antigen 125(CA125)in the experimental group were significantly lower than those in the control group[(30.01±3.32)vs.(38.19±4.47)U/ml,(4.28±0.43)vs.(6.07±0.69)ng/ml,(31.62±3.37)vs.(35.74±3.60)U/ml,t=11.393,16.892,6.443,P<0.01].After treatment,the levels of cluster of differentiation 3^(+)(CD3^(+))and cluster of differentiation 4^(+)(CD4^(+))in the experimental group were significantly higher than those in the control group(60.90±5.19 vs.55.19±4.47 and 38.10±3.60 vs.34.06±3.23,t=6.453 and 6.455,P<0.01).After treatment,the cluster of differentiation 8^(+)(CD8^(+))level in the experimental group was significantly lower than that in the control group(27.39±2.96 vs.31.72±3.19,t=7.696,P<0.01).After treatment,the levels of total cholesterol(TC),triglycerides(TG),and low-density lipoprotein cholesterol(LDL-C)in the experimental group were significantly lower than those in the control group[(4.01±0.36)vs.(4.69±0.53)mmol/L,(1.06±0.12)vs.(1.36±0.14)mmol/L,(2.02±0.17)vs.(2.32±0.22)mmol/L,t=8.134,12.156,8.565,P<0.01].After treatment,the high-density lipoprotein cholesterol(HDL-C)levels in the experimental group were significantly higher than those in the control group[(2.52±0.21)vs.(1.85±0.19)mmol/L,t=18.319,P<0.01).Conclusion Trastuzumab combined with arbacilli has significant clinical efficacy in the treatment of advanced Her-2 positive breast cancer patients,which can significantly improve the level of tumor markers,immune function and blood lipid level of patients.
作者
秦承东
俞洋
扈杰杰
徐丹英
Qin Chengdong;Yu Yang;Hu Jiejie;Xu Danying(Department of Breast Surgery,Zhejiang Cancer Hospital,Hangzhou 310000,China;Department of Breast Surgery,Second Affiliated Hospital of Jiaxing University,Jiaxing 314000,China)
出处
《中华实验外科杂志》
2025年第7期1340-1344,共5页
Chinese Journal of Experimental Surgery
