蒋轶 左宏波 王志

【摘要】 目的：探讨双靶方案联合多西他赛治疗人表皮生长因子受体2（Her-2）阳性转移性乳腺癌患者的效果。方法：选取2018年11月-2019年12月本院收治的80例Her-2阳性转移性乳腺癌患者，按随机数字表法将其分为试验组和对照组，各40例。对照组行曲妥珠单抗+多西他赛治疗，试验组在对照组基础上加用帕妥珠单抗治疗。比较两组治疗效果、肿瘤标志物水平、生活质量及不良反应发生情况。结果：试验组治疗总有效率高于对照组（P<0.05）。治疗后，试验组癌相关糖蛋白抗原（CA153）、组织多肽特异性抗原（TPS）及癌胚抗原（CEA）水平均低于对照组（P<0.05）。治疗后6个月，试验组生活质量评分高于对照组（P<0.05）。试验组不良反应发生率低于对照组（P<0.05）。结论：双靶方案联合多西他赛治疗Her-2阳性转移性乳腺癌可提高治疗总有效率，降低肿瘤标志物水平，提升治疗安全性与生活质量。

【关键词】 转移性乳腺癌 人表皮生长因子受体2 曲妥珠单抗 多西他赛 帕妥珠单抗

[Abstract] Objective： To investigate the effect of dual target regimen combined with Docetaxel on patients with human epidermal growth factor receptor 2 （Her-2） positive metastatic breast cancer. Method： A total of 80 patients with Her-2 positive metastatic breast cancer admitted to our hospital from November 2018 to December 2019 were selected. They were divided into experimental group and control group according to the random number table method， 40 patients in each group. The control group was treated with Trastuzumab + Docetaxel， and the experimental group was treated with Pertuzumab on the basis of the control group. The treatment effect， tumor marker level， quality of life and adverse reactions were compared between two groups. Result： The total effective rate of the experimental group was higher than that of the control group （P<0.05）. After treatment， the levels of cancer-associated glycoprotein antigen （CA153）， tissue polypeptide specific antigen （TPS） and carcinoembryonic antigen （CEA） in the experimental group were lower than those in the control group （P<0.05）. At 6 months after treatment， the quality of life score of the experimental group was higher than that of the control group （P<0.05）. The incidence of adverse reactions in the experimental group was lower than that in the control group （P<0.05）. Conclusion： The treatment of Her-2 positive metastatic breast cancer with dual target regimen combined with Docetaxel can improve the total effective rate， reduce the level of tumor markers， improve the safety of treatment and quality of life.

[Key words] Metastatic breast cancer Human epidermal growth factor receptor 2 Trastuzumab Docetaxel PertuzumabFirst-authors address： The First Peoples Hospital of Jiujiang City， Jiujiang 332000， China

乳腺癌中約有30%存在人表皮生长因子受体2（Her-2）阳性，提示患者预后较差[1-2]。多西他赛、曲妥珠单抗是临床治疗本病的常用手段，前者能经结合Her-2受体，抑制人表皮生长因子附着于Her-2，拮抗肿瘤生长;后者能够通过与游离微管蛋白相结合，促进微管蛋白装配成微管，拮抗其解聚，使微管蛋白数量减少，阻碍肿瘤细胞有丝分裂[3-4]。帕妥珠单抗可经结合Her-2受体，抑制Her-2受体二聚化而发挥拮抗作用，控制肿瘤生长。本研究旨在分析双靶方案联合多西他赛对Her-2阳性转移性乳腺癌患者预后的影响，现报道如下。

1 资料与方法

1.1 一般资料 选取2018年11月-2019年12月就诊于本院的80例Her-2阳性转移性乳腺癌患者。纳入标准：经病理学检查和免疫组化检验确诊为Her-2阳性转移性乳腺癌的女性患者;预计生存期≥3个月。排除标准：对化疗耐受性极差;其他恶性肿瘤史;既往有手术史、外伤史;身体组织器官感染;精神疾患。……