2021 年第 2 期 第 16 卷

吡柔比星联合多西他赛新辅助化疗对年轻女性乳腺癌患者临床疗效和癌组织中肿瘤增殖相关因子表达情况的影响

Effect of pirarubicin combined with docetaxel neoadjuvant chemotherapy on clinical efficacy and tumor proliferation-related factors expression in young women with breast cancer

作者：王孝伟郑默然张玉英朱培李艳董超鹏

英文作者：Wang Xiaowei Zheng Moran Zhang Yuying Zhu Pei Li Yan Dong Chaopeng

单位：山东省菏泽市立医院乳腺甲状腺外科274031

英文单位：Department of Breast and Thyroid Surgery Heze Municipal Hospital Shandong Province Heze 274031 China

关键词：乳腺癌；多西他赛；吡柔比星；人表皮生长因子受体2；细胞增殖核抗原Ki-67；血管内皮生长因子

英文关键词：Breastcancer;Docetaxel;Pirarubicin;Humanepidermalgrowthfactorreceptor-2;CellproliferationnuclearantigenKi-67;Vascularendothelialgrowthfactor 

• 摘要：

• 目的 探究吡柔比星联合多西他赛新辅助化疗对年轻（≤40岁）女性乳腺癌患者临床疗效和癌组织中细胞增殖核抗原Ki-67、人表皮生长因子受体2（Her-2）、血管内皮生长因子（VEGF）等肿瘤增殖相关因子表达情况的影响。方法 选取山东省菏泽市立医院2018年1月至2020年1月收治的≤40岁女性乳腺癌患者80例，应用随机数字表法分为对照组和观察组，各40例。对照组接受多西他赛化疗，观察组接受多西他赛联合吡柔比星化疗，3周为1个周期，2组均持续治疗3个周期。比较2组患者治疗3个周期后的临床疗效和治疗前后癌组织中Ki-67、Her-2、VEGF阳性表达率以及治疗期间毒副作用发生情况。结果 治疗3个周期后，观察组总有效率高于对照组［75.0%（30/40）比52.5%（21/40）］(χ2=4.381,P=0.036)。治疗前，2组患者癌组织中Ki-67、Her-2、VEGF阳性表达率比较差异均无统计学意义（均P＞0.05）；治疗3个周期后，对照组癌组织中Ki-67、Her-2、VEGF阳性表达率与治疗前比较差异均无统计学意义（均P＞0.05），观察组癌组织中Ki-67、VEGF阳性表达率均低于治疗前［22.5%(9/40)比57.5%（23/40），42.5%（17/40）比77.5%（31/40）］，且均低于对照组［45.0%(18/40)、65.0%（26/40）］（均P<0.05），Her-2阳性表达率与治疗前和对照组比较差异均无统计学意义（均P>0.05）。治疗期间，观察组化疗毒副作用发生率与对照组比较，差异无统计学意义（P=0.531）。结论 吡柔比星联合多西他赛新辅助化疗可抑制年轻女性乳腺癌患者癌组织中Ki-67和VEGF的表达，提高临床疗效，且与单用多西他赛比较并未增加化疗毒副作用，治疗前Her-2阳性可能影响化疗效果，临床需引起重视。

• Objective To investigate the clinical efficacy of pirarubicin combined with docetaxel neoadjuvant chemotherapy in young (≤40 years old) women with breast cancer and its influence on cell proliferation nuclear antigen Ki-67, human epidermal growth factor receptor 2 (Her-2) and vascular endothelial growth factor (VEGF) tumor proliferation related factor expression in cancer tissues. Methods Totally 80 cases of breast cancer patients ≤40 years old admitted to Heze Municipal Hospital, Shandong Province from January 2018 to January 2020 were selected. The patients were randomly divided into the control group and the observation group, with 40 cases in each group. The control group received docetaxel chemotherapy, and the observation group received docetaxel combined with pirarubicin chemotherapy, both groups received continuous treatment for 3 cycles(3 weeks was a cycle). The clinical efficacy after 3 cycles of treatment, the positive expression rates of Ki-67, Her-2 and VEGF in cancer tissues before and after treatment, and the occurrence of toxic and side effects during treatment were compared between the two groups. Results  After 3 cycles of treatment, the total effective rate in the observation group was higher than that in the control group ［75.0%(30/40) vs 52. 5%(21/40), χ2=4.381, P=0.036］. Before treatment, there were no statistically significant differences in the positive expression rates of Ki-67, Her-2 and VEGF in the cancer tissues of the two groups (all P>0.05). After 3 cycles of treatment, there were no significant differences in positive expression rates of Her-2, Ki-67 and VEGF in the control group compared with those before treatment (all P>0.05); the positive expression rates of Ki-67, VEGF in the cancer tissues of the observation group were lower than those before treatment ［22.5%(9/40) vs 57.5%(23/40), 42.5%(17/40) vs 77.5%(31/40)］, and both of them in the observation group were lower those of the control group ［45.0%(18/40), 65.0%(26/40)］(all P<0.05). There was no statistically significant difference between the positive expression rate of Her-2 in observation group before and after treatment (P>0.05). There was no statistically significant difference in incidence of toxic and side effects of chemotherapy between the two groups during treatment(P=0.531). Conclusions Pirarubicin combined with docetaxel neoadjuvant chemotherapy can inhibit the expressions of Ki-67 and VEGF in the cancer tissues of young women with breast cancer and improve the clinical efficacy. Moreover, compared with docetaxel alone, it doesn′t increase the toxic and side effects of chemotherapy. Positive expression of Her-2 before treatment may affect the efficacy of chemotherapy, which should be paid attention to clinically.