摘要
目的探讨雌激素受体(estrogen receptor,ER)阳性(ER+)和雌激素受体阴性(ER-)不同分子亚型乳腺癌术后辅助化学药物治疗(简称化疗)中加用脾多肽的临床免疫疗效。方法在山西省肿瘤医院乳腺外科2014年1月至2017年12月收治的原发乳腺癌术后辅助化疗的患者201例,其中109例ER+乳腺癌患者,92例ER-乳腺癌患者。ER+组乳腺癌患者采用数字表法随机分为实验亚组和对照亚组,对照组采用常规的化疗方案,实验组在对照组的基础上加用脾多肽注射液,比较两亚组治疗前后的免疫功能及不良反应的影响。ER-组也采用同样的处理。结果ER+实验亚组和对照亚组相比,T细胞总数、CD4^+、CD8^+在治疗前后差异有统计学意义(P<0.05),且治疗后T细胞总数、CD4^+、CD8^+均增高;可溶性白细胞介素-2受体(soluble interleukin-2 receptor,SiL-2R)和恶性肿瘤特异性生长因子(tumor specific growth factor,TSGF)浓度下降,差异具有统计学意义(P<0.05),重度(Ⅲ、IV度)骨髓抑制比例降低,发生口腔黏膜炎的比例下降,严重恶心呕吐(Ⅲ、IV度)患者比例明显降低,化疗血液毒性和消化道反应明显减轻。ER-实验亚组和对照亚组相比,治疗后总T细胞、CD4^+、CD8^+显著增高,差异有统计学意义;Sil-2R显著降低,差异有统计学意义;同时化疗血液毒性和消化道反应明显减轻。结论脾多肽注射液在不同分子亚型乳腺癌术后辅助化疗中均能提高患者免疫功能、减轻化疗不良反应,值得在临床上进一步推广。
Objective In this study,the effects of lienal polypeptide injection(LPI)combined postoperative chemotherapy on patients with breast cancer were explored.Methods Totally 201 cases with primary breast cancer from January 2014 to December 2017 received adjuvant chemotherapy,including 109 cases with estrogen receptor positive(ER+)breast cancer and 92 cases with ER negative(ER-)breast cancer in Shanxi Province Cancer Hospital.Breast cancer patients in the ER+group were randomly divided into the experimental subgroup and the control subgroup.The control subgroup was treated with conventional chemotherapy,and the experimental group was additionally given LPI.The effects of immune function,toxic and side effects in the two subgroups were compared.The same process was used for ER-groups.Results Compared with the control subgroup,the total number of T cells,CD4^+and CD8^+in the ER^+experimental subgroup and in the ER-experimental subgroup were significantly different before and after treatment(P<0.05),and the total number of T cells,CD4^+and CD8^+were increased after treatment.Compared with the control subgroup,the levels of soluble interleukin receptor-2(SiL-2R)and malignant tumor specific growth factor(TSGF)in ER^+experimental subgroup were significantly different before and after treatment(P<0.05),and Sil-2R and TSGF decreased.Compared with the control subgroup,Sil-2R decreased significantly in the ER-experimental subgroup.The proportion of severe myelosuppression(gradeⅢ,IV)was decreased,the proportion of oral mucositis was decreased,and the proportion of severe nausea and vomiting(gradeⅢ,IV)was significantly reduced.The adverse reactions of high grade were greatly relieved in the ER^+experimental subgroup and in the ER-experimental subgroup.Conclusion It has improved that LPI is effective in improving the immune function,which is worth promoting in the clinical practices.
作者
白向东
郝雅婷
张欣雪
贺强
Bai Xiangdong;Hao Yating;Zhang Xinxue;He Qiang(The Third Department of Breast Surgery,Shanxi Cancer Hospital,Taiyuan030013,China;Department of General Surgery,Beijing Chaoyang Hospital,Capital Medical University,Beijing 100020,China)
出处
《首都医科大学学报》
CAS
北大核心
2019年第3期443-448,共6页
Journal of Capital Medical University
基金
国家自然科学基金面上项目(81471590)~~
关键词
脾多肽
雌激素受体
乳腺癌
免疫功能
lienal polypeptide injection(LPI)
estrogen receptor
breast cancer
immune function
