王鑫

[摘要] 目的 研究表柔比星（EPI）聯合多西他赛（DOC）新辅助化疗治疗乳腺癌临床效果及其对患者癌组织细胞增殖核抗原（Ki-67）表达的影响。 方法 选取我院于2018年1月至2019年3月收治的70例乳腺癌患者，将其随机分为对照组与观察组，每组各35例。两组均接受新辅助化疗，对照组采用5-氟尿嘧啶（5-FU）联合EPI治疗方案，观察组采用EPI联合DOC治疗方案，对比两组患者治疗效果、治疗前后的Ki-67及细胞增殖核抗原信使RNA蛋白表达水平、生活质量以及不良反应发生情况。 结果 观察组患者的治疗总有效率为80.00%，明显高于对照组的60.00%，差异有统计学意义（t=9.523，P<0.05）;治疗前两组的Ki-67mRNA、Ki-67蛋白表达水平比较，差异无统计学意义（P>0.05），治疗后观察组Ki-67mRNA、Ki-67蛋白表达水平明显低于对照组，差异有统计学意义（P<0.05）;且观察组生活质量各项评分均明显高于对照组，差异有统计学意义（P<0.05）;观察组与对照组的不良反应发生率（脱发、消化道反应、骨髓抑制、心律失常、肝功能异常）比较，差异无统计学意义（P>0.05）。 结论 针对乳腺癌患者采用EPI联合DOC新辅助化疗治疗效果尤为显著，能够有效改善患者的临床症状，调节癌组织Ki-67表达水平，有助于提高患者的生活质量，在临床上具有应用价值。

[关键词] 乳腺癌;表柔比星;多西他赛;新辅助化疗

[中图分类号] R737.9          [文献标识码] B          [文章编号] 1673-9701（2021）11-0092-04

Clinical effect of epirubicin combined with docetaxel neoadjuvant chemotherapy in the treatment of breast cancer and its influence on the expression of Ki-67 in cancer tissues

WANG Xin

Department of Breast Surgery， Jiamusi Women and Children′s Hospital in Heilongjiang Province， Jiamusi   154000， China

[Abstract] Objective To study the clinical effect of epirubicin（EPI） combined with docetaxel（DOC） neoadjuvant chemotherapy in the treatment of breast cancer and its effect on the expression of proliferating nuclear antigen（Ki-67） in cancer tissues. Methods A total of 70 breast cancer patients who were admitted to our hospital from January 2018 to March 2019 were selected and randomly divided into the control group and the observation group，with 35 cases in each group. Both groups were given neoadjuvant chemotherapy. The control group was given 5-fluorouracil（5-FU） combined with EPI for the treatment plan. The observation group was given EPI combined with DOC for the treatment plan. The treatment effects， protein expression levels of Ki-67 and cell proliferating nuclear antigen messenger RNA before and after treatment， quality of life and adverse reactions were compared between the two groups. Results The total effective rate in the treatment in the observation group was 80.00%，which was higher than that of 60.00% in the control group，with significant difference（t=9.523， P<0.05）; There was no difference of the Ki-67mRNA and Ki-67 protein levels between the two groups before treatment（P>0.05）. After treatment， the Ki-67mRNA and Ki-67 protein levels in the observation group were significantly lower than those in the control group，with significant difference（P<0.05）. The quality of life scores in the observation group were significantly higher than those in the control group，with significant difference（P<0.05）. There was no significant difference of adverse reactions incidence（hair loss， gastrointestinal reactions， bone marrow suppression， arrhythmia， abnormal liver function） between the observation group and the control group（P>0.05）. Conclusion EPI combined with DOC neoadjuvant chemotherapy is particularly effective for breast cancer patients. It can effectively improve the clinical symptoms of patients， regulate the expression of Ki-67 in cancer tissues， and help improve the quality of life of patients， which has a clinical application value.

[Key words] Breast cancer; Epirubicin; Docetaxel; Neoadjuvant chemotherapy

乳腺癌是临床常见的妇科疾病，近年来随着人们生活方式的改变，该病也呈现为逐年增长趋势[1]。有研究显示，乳腺癌患者的5年生存率约为55.0%，作为临床常见的女性恶性肿瘤之一，致死率较高，其主要原因在于患者的病情发生、癌细胞发生转移情况。乳腺癌是由于不同病因产生致癌因子，引起乳腺上皮细胞出现增殖失控，进而恶变的情况，主要表现为乳腺存在肿块、伴有疼痛且腋窝淋巴结肿大等[2]。目前对于该病的治疗主要是以化疗为主，而合理有效的化疗方案对于患者预后而言尤为关键，需要同时满足稳定病情和延长生命等效果，但由于化疗方案中采用的药物多种多样，其效果大不相同[3]。……