曾世彬 徐焱尧 李鹰飞

【摘要】 目的：觀察华蟾素胶囊联合TX方案化疗治疗转移性乳腺癌的效果和对免疫功能的影响。

方法：回顾性分析2015年6月-2018年9月本院收治的106例乳腺癌患者的临床资料，根据治疗方法不同分为对照组52例和观察组54例。对照组采用多西他赛联合卡培他滨片治疗，观察组在对照组基础上联合华蟾素胶囊治疗。两组患者化疗4个疗程后行影像学检查评价疗效，并在治疗前后抽取两组患者外周血检测细胞因子水平及免疫功能变化。结果：治疗后，观察组DCR、ORR均显著高于对照组（P<0.05）。观察组治疗后血清IL-2水平明显高于治疗前，IL-6水平显著低于治疗前;对照组治疗后血清IL-2水平明显低于治疗前，IL-6水平显著高于治疗前（P<0.05）。观察组治疗后血清IL-2明显高于对照组，而IL-6水平显著低于对照组（P<0.05）。与治疗前比较，观察组治疗后CD3+、CD4+、NK细胞水平均明显升高，而CD8+细胞水平显著下降，CD4+/CD8+比值显著升高（P<0.05）。对照组治疗后CD3+、CD4+、NK细胞水平和CD4+/CD8+比值均显著低于观察组，而CD8+水平显著高于观察组（P<0.05）。治疗后，观察组DCR亚组CD4+、NK细胞水平均明显高于对照组的DCR亚组，CD8+细胞水平明显低于对照组的DCR亚组，差异均有统计学意义（P<0.05）。结论：华蟾素胶囊联合TX方案化疗可有效提高转移性乳腺癌患者的临床效果，增强免疫功能。

【关键词】 华蟾素胶囊; 转移性乳腺癌; 免疫功能

【Abstract】 Objective：To observe the efficacy of Cinobufotalin Capsules combined with TX regimen in the treatment of metastatic breast cancer（MBC）and its effects on immune function.Method：Clinical data of 106 breast cancer patients admitted to our hospital from June 2015 to September 2018 were retrospectively analyzed，according to different treatment methods，the patients were divided into control group（n=52）and observation group（n=54）.The control group was treated with Docetaxel combined with Capecitabine Tablets，and the observation group was treated with Cinobufotalin Capsules on the basis of control group.Imaging examination was performed after 4 courses of chemotherapy in the two groups to evaluate the efficacy，and peripheral blood samples of the two groups were taken before and after treatment to detect cytokine levels and immune function changes.Result：After treatment，DCR and ORR in the observation group were significantly higher than those in the control group（P<0.05）.After treatment，the level of serum IL-2 in the observation group was significantly higher than that before treatment，and the level of IL-6 was significantly lower than that before treatment;after treatment，the level of serum IL-2 in the control group was significantly lower than that before treatment，and the level of IL-6 was significantly higher than that before treatment（P<0.05）.After treatment，the level of serum IL-2 in the observation group was significantly higher than that in the control group，while the level of IL-6 in the observation group was significantly lower than that in the control group（P<0.05）.Compared with before treatment，the levels of CD3+，CD4+，NK cells in the observation group increased significantly after treatment，while the levels of CD8+ decreased significantly，and the ratio of CD4+/CD8+ increased significantly（P<0.05）.After treatment，the levels of CD3+，CD4+，NK cells and the ratio of CD4+/CD8+ in the control group were significantly lower than those in the observation group，while the level of CD8+ was significantly higher than that in the observation group（P<0.05）.After treatment，the levels of CD4+ and NK cells in the DCR subgroup of the observation group were significantly higher than those in the DCR subgroup of control group，and the level of CD8+ cell was significantly lower than that in the DCR subgroup of control group，with statistically significant differences（P<0.05）.

Conclusion：Cinobufotalin Capsules combined with TX regimen chemotherapy can effectively improve the clinical efficacy and enhance immune function of patients with MBC.

【Key words】 Cinobufotalin Capsules; Metastatic breast cancer; Immune function

First-authors address：The First Peoples Hospital of Fuzhou，Fuzhou 344000，China

doi：10.3969/j.issn.1674-4985.2019.17.001

乳腺癌是威胁中国妇女健康最常见的恶性肿瘤之一[1]，根据中国恶性肿瘤发病和死亡分析，乳腺癌位居女性恶性肿瘤发病率首位，死亡率位居第5位，且发病率逐年升高[2-3]。尽管乳腺癌治疗方案不断规范化及多学科综合治疗，但是5年内仍有20%～60%乳腺癌患者发生转移，大部分转移性乳腺癌（metastatic breast cancer，MBC）患者难以治愈，平均生存时间为2～3年[4]。近年来研究表明，华蟾素的药理作用是通过抑制肿瘤细胞的生长、诱导其凋亡、增强机体免疫功能等多方面发挥其抗肿瘤作用[5]。华蟾素与化疗药物联合应用在非小细胞肺癌、胃癌、结直肠癌、胰腺癌等恶性肿瘤治疗中可以提高效果，减轻毒副反应[6-8]，但在乳腺癌的临床应用文献报道较少。本研究采用华蟾素联合化疗治疗转移性乳腺癌患者，观察联合用药疗效，并探索其抗肿瘤机制。现将研究结果报道如下。……