崔斌斌　吴增贵　王玉玲

[摘要] 目的 探討人表皮生长因子受体2（HER-2）阳性晚期乳腺癌患者给予曲妥珠单抗联合含紫杉类方案治疗的临床效果。 方法 从台州医院2012年1月～2015年1月期间诊治的HER-2阳性晚期乳腺癌患者中选取74例作研究对象，并根据治疗方案不同分成两组：对照组（n=37）单纯应用紫杉类方案，研究组（n=37）予曲妥珠单抗联合含紫杉类方案治疗，对两组患者的整体疗效、3年生存率、安全性及肿瘤标志物变化进行统计学分析。 结果 ①研究组患者整体化疗缓解率为45.95%，较对照组患者整体化疗缓解率21.62%高（P<0.05）；②研究组患者的3年生存率为37.84%，与对照组患者3年生存率16.22%相比较高（P<0.05）；③治疗前，研究组和对照组三项血清肿瘤标志物水平比较均无统计学差异（均P>0.05）；治疗后，研究组患者的CEA、CA125、CA153水平均低于对照组，且三项指标之间的统计学对比差异明显（均P<0.05）；③两组不良反应发生率比较无统计学差异（P>0.05）。 结论 HER-2阳性晚期乳腺癌给予曲妥珠单抗联合含紫杉类方案治疗的临床效果确切，可提高患者的3年生存率，且能在一定程度上改善血清肿瘤标志物水平。

[关键词] HER-2阳性晚期乳腺癌；曲妥珠单抗；紫杉类；生存率；血清肿瘤标志物

[中图分类号] R737.9 [文献标识码] B [文章编号] 1673-9701（2018）12-0076-04

Effectiveness of treatment combing trastuzumab and taxanes in patients with HER-2 positive advanced breast cancer

CUI Binbin WU Zenggui WANG Yuling

Department of Neurology， Taizhou Hospital of Enze Medical Group， Taizhou， Zhejiang 317000， China

[Abstract] Objective To investigate the clinical effectiveness of treatment combining trastuzumab and taxanes in patients with human epidermal growth factor receptor 2（HER-2） positive advanced breast cancer. Methods 74 patients with HER-2 positive advanced breast cancer in Taizhou Hospital from January 2012 to January 2015 were selected and divided into two group： control group （n=37） with the treatment of taxanes only， study group （n=37） with the treatment combining trastuzumab with taxanes. The overall effectiveness， 3-year survival rate， safety and the changes of tumor markers in two groups were statistically analyzed. Results ①The overall remission rate of chemotherapy in study group was 45.95%， higher than that in control group （21.62%） （P<0.05）. ②The 3-year survival rate in study group was 37.84%， higher than that in control group （16.22%） （P<0.05）. ③The levels of three serum tumor markers before treatment were not significantly different between study and control group（P>0.05）. The levels of CEA， CA125 and CA153 after treatment in study group were statistically lower than those in control group respectively （P<0.05）. ③There was no statistical difference of the incidence of adverse reaction between two groups（P>0.05）. Conclusion The clinical effectiveness of treatment combing trastuzumab and taxanes in patients with HER-2 positive advanced breast cancer is confirmed. It can improve the 3-year survival rate and correct the levels of serum tumor markers. It is worth recommendation.

[Key words] HER-2 positive advanced breast cancer； Trastuzumab； Taxanes； Survival Rate； serum Tumor Marker

据报道，30%乳腺癌患者存在人表皮生长因子受体2（HER-2）阳性表达情况，HER-2是一种跨膜络氨酸激酶，相对分子质量是185×103，与表皮生长因子受体同源[1]。当前，临床上对于晚期乳腺癌患者主要采取化疗，由于曲妥珠单抗是一种具备拮抗HER-2功效的人源化单克隆抗体，因而临床医师在治疗HER-2阳性晚期乳腺癌患者中多采取曲妥珠单抗[2]。有学者研究发现，对HER-2阳性晚期乳腺癌患者应用曲妥珠单抗联合含紫杉类方案的化疗效果肯定，其化疗有效率高达59%[3]，然而相关报道较少，上述观点缺乏足够实验依据支持。……