蒽环类药物联合紫杉醇对局部晚期乳腺癌患者T淋巴细胞亚群功能的影响
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摘要
目的探讨蒽环类药物联合紫杉醇对局部晚期乳腺癌患者T淋巴细胞亚群功能的影响,为临床治疗局部晚期乳腺癌患者提供参考。方法选取我院2014年4月～2017年10月收治的63例局部晚期乳腺癌患者作为研究对象,按照随机数字表法分为研究组(n=32)和对照组(n=31)。研究组患者接受蒽环类药物联合紫杉醇(AT)方案实施新辅助化疗;对照组患者接受蒽环类药物为主的(CEF)方案治疗。比较两组患者治疗前后的T淋巴细胞亚群水平及不良反应发生率。结果研究组患者治疗后的自然杀伤(NK)细胞、CD3~+及CD4~+/CD8~+水平高于对照组,CD8~+水平低于对照组,差异均有统计学意义(P<0.05);两组患者的骨髓抑制、恶心呕吐和脱发等不良反应发生率比较,差异无统计学意义(P>0.05)。结论蒽环类药物联合紫杉醇治疗局部晚期乳腺癌患者可有效保护患者的T淋巴细胞功能,提高患者的细胞免疫功能,对于改善患者的临床预后具有重要的意义。
Objective To investigate the effect of anthracyclines combined with Paclitaxel on T lymphocyte subsets in patients with locally advanced breast cancer, and to provide reference for clinical treatment of locally advanced breast cancer. Methods Sixty-three patients with locally advanced breast cancer admitted to our hospital from April 2014 to October 2017 were selected as the study subjects, they were divided into study group(n=32) and control group(n=31) according to random number table method. The study group received neoadjuvant chemotherapy with anthracyclines combined with Paclitaxel(AT) regimen, while the control group received anthracycline-based(CEF) regimen. The levels of T lymphocyte subsets and the incidence of adverse reactions were compared between the two groups before and after treatment. Results The levels of natural killer(NK) cells, CD3~+ and CD4~+/CD8~+ in the study group were higher than those in the control group, and the levels of CD8~+ in the study group were lower than those in the control group, the differences were statistically significant(P<0.05). There were no significant differences in the incidence of bone marrow suppression, nausea, vomiting and alopecia between the two groups(P>0.05). Conclusion Anthracyclines combined with Paclitaxel in the treatment of locally advanced breast cancer can effectively protect the T lymphocyte function and improve the cellular immune function of patients, which is of great significance to improve the clinical prognosis of patients.
Objective To investigate the effect of anthracyclines combined with Paclitaxel on T lymphocyte subsets in patients with locally advanced breast cancer, and to provide reference for clinical treatment of locally advanced breast cancer. Methods Sixty-three patients with locally advanced breast cancer admitted to our hospital from April 2014 to October 2017 were selected as the study subjects, they were divided into study group(n=32) and control group(n=31) according to random number table method. The study group received neoadjuvant chemotherapy with anthracyclines combined with Paclitaxel(AT) regimen, while the control group received anthracycline-based(CEF) regimen. The levels of T lymphocyte subsets and the incidence of adverse reactions were compared between the two groups before and after treatment. Results The levels of natural killer(NK) cells, CD3~+ and CD4~+/CD8~+ in the study group were higher than those in the control group, and the levels of CD8~+ in the study group were lower than those in the control group, the differences were statistically significant(P<0.05). There were no significant differences in the incidence of bone marrow suppression, nausea, vomiting and alopecia between the two groups(P>0.05). Conclusion Anthracyclines combined with Paclitaxel in the treatment of locally advanced breast cancer can effectively protect the T lymphocyte function and improve the cellular immune function of patients, which is of great significance to improve the clinical prognosis of patients.
引文
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[10]杨思福,黄建瑾.吉西他滨联合长春瑞滨治疗耐药性晚期乳腺癌疗效观察[J].实用肿瘤杂志,2015,30(5):462-464.
[11]Nahleh ZA,Barlow WE,Hayes DF,et al.SWOG S0800(NCL CDR0000636131):addition of bevacizumab to neoadjuvant nab-paclitaxel with dose-dense doxorubicin and cyclophosphamide improves pathologic complete response(pCR)rates in inflammatory or locally advanced breast cancer[J].Breast Cancer Res Treat,2016,158(3):485-495.
[12]刘海英,陈超庭.不同剂量蒽环类药物对乳腺癌术前化疗的临床效果探讨[J].临床医药文献杂志,2017,4(76):15 006-15 010.
[13]申婧,曹海英.紫杉醇联合顺铂治疗晚期卵巢癌患者的疗效及免疫功能的影响[J].中国肿瘤临床与康复,2016,23(7):790-793.
[14]吴姗姗,严峰,邓玉玲,等.小细胞和非小细胞肺癌晚期患者CD3+CD4+及CD3+CD8+T淋巴细胞亚群的差异[J].中国免疫学杂志,2015,31(2):114-121.
[15]张国顺,黄晓阳,李守民.外周血CD3+、CD4+、CD8+、CD19+水平与喉癌患者预后的相关性[J].实用癌症杂志,2017,32(5):735-737.
[16]Wilcken NR,Stockler MR.Individual patient meta-analysis:taxane plus anthracycline reduces mortality from early breast cancer[J].Ann Intern Med,2012,156(12):6-4.
[2]汤红平,钟琳,姜辉,等.lncRNA ANRIL在乳腺癌中的作用及机制研究[J].中国医药导报,2018,15(16):17-20,封3.
[3]Gandini S,Guerrieri-Gonzaga A,Pruneri G,et al.Association of molecular subtypes with Ki-67 changes in untreated breast cancer patients undergoing pre-surgical trials[J].Ann Oncol,2014,25(3):618-623.
[4]张崇建,秦丽,王璐,等.乳腺癌新辅助化疗疗效的影响因素及预后分析[J].中国老年学杂志,2016,36(3):636-637.
[5]邵龙,毕美娥,周春兰.高频彩超及X线钼靶检查对乳腺原位癌早期诊断价值的对照分析[J].转化医学电子杂志,2015,2(6):18-19.
[6]谢峰,陈昌南,林云笑,等,紫衫醇联合表柔比星对中晚期乳腺癌患者的远期疗效[J].河南医学研究,2017,26(10):1793-1794.
[7]魏文嵩.表柔比星联合紫杉醇脂质体的新辅助化疗方法治疗三阴性乳腺癌的效果[J].中国当代医药,2016,23(35):65-68.
[8]包中会,陈燕,任洪波,等.三阴乳腺癌术后辅以密集化疗的临床疗效[J].现代肿瘤医学,2016,24(14):2221-2224.
[9]白海亚,龚晓军,刘慧民,等.CD4+/CD8+在评价局部进展期乳腺癌新辅助化疗疗效中的应用价值[J].中国优生优育,2014,20(3):129-132.
[10]杨思福,黄建瑾.吉西他滨联合长春瑞滨治疗耐药性晚期乳腺癌疗效观察[J].实用肿瘤杂志,2015,30(5):462-464.
[11]Nahleh ZA,Barlow WE,Hayes DF,et al.SWOG S0800(NCL CDR0000636131):addition of bevacizumab to neoadjuvant nab-paclitaxel with dose-dense doxorubicin and cyclophosphamide improves pathologic complete response(pCR)rates in inflammatory or locally advanced breast cancer[J].Breast Cancer Res Treat,2016,158(3):485-495.
[12]刘海英,陈超庭.不同剂量蒽环类药物对乳腺癌术前化疗的临床效果探讨[J].临床医药文献杂志,2017,4(76):15 006-15 010.
[13]申婧,曹海英.紫杉醇联合顺铂治疗晚期卵巢癌患者的疗效及免疫功能的影响[J].中国肿瘤临床与康复,2016,23(7):790-793.
[14]吴姗姗,严峰,邓玉玲,等.小细胞和非小细胞肺癌晚期患者CD3+CD4+及CD3+CD8+T淋巴细胞亚群的差异[J].中国免疫学杂志,2015,31(2):114-121.
[15]张国顺,黄晓阳,李守民.外周血CD3+、CD4+、CD8+、CD19+水平与喉癌患者预后的相关性[J].实用癌症杂志,2017,32(5):735-737.
[16]Wilcken NR,Stockler MR.Individual patient meta-analysis:taxane plus anthracycline reduces mortality from early breast cancer[J].Ann Intern Med,2012,156(12):6-4.