蒋海英

【摘要】  目的  探讨曲妥珠单抗与帕妥珠单抗双靶向联合化疗药物治疗人表皮生长因子受体2（HER-2）阳性乳腺癌的临床效果。方法  选择2018年3月- 2023年6月六盘水市人民医院收治的72例HER-2阳性乳腺癌患者，根据组间基线资料均衡可比的原则，按随机数字表法分成两组，每组36例。两组患者均采取多西他赛联合卡铂治疗，在此基础上对照组加曲妥珠单抗治疗7个疗程，观察组则应用曲妥珠单抗与帕妥珠单抗双靶向联合治疗7个疗程。对比两组患者的临床疗效、治疗前后血清指标[糖类抗原125（CA-125）、糖类抗原153（CA-153）]水平及治疗期间不良反应情况。结果  观察组患者的治疗有效率（80.55%）显著高于对照组（50.00%），组间差异有统计学意义（P<0.05）。治疗前，两组患者CA-125、CA-153血清指标水平比较，差异均无统计学意义（P>0.05）；治疗7个疗程后，两组患者CA-125、CA-153血清指标水平均降低，但观察组低于对照组，差异有统计学意义（P<0.05）。治疗期间，对照组患者的不良反应发生率为11.11%，低于观察组的13.89%，但组间差异无统计学意义（P>0.05）。结论  对于HER-2阳性乳腺癌，采取曲妥珠单抗与帕妥珠单抗双靶向联合化疗药物治法，治疗效果好，显著降低血清CA-125、CA-153水平，同时不增加不良反应发生率。

【关键词】  人表皮生长因子受体2；乳腺癌；化疗；曲妥珠单抗；帕妥珠单抗

中图分类号  R737.9   文献标识码  A    文章编号  1671-0223（2024）13--03

Application of trastuzumab and parstuzumab double targeted chemotherapy in human epidermal growth factor receptor 2 positive breast cancer  Jiang Haiying. Department of Oncology and Hematology， Liupanshui People's Hospital， Liupanshui 553000， China

【Abstract】  Objective To investigate the clinical effect of trastuzumab and patouzumab combined with chemotherapy in the treatment of human epidermal growth factor receptor 2 （HER-2） positive breast cancer. Methods   A total of 72 HER-2 positive breast cancer patients admitted to Liupanshui People's Hospital from March 2018 to June 2023 were selected. According to the principle of balanced and comparable baseline data between groups， they were divided into two groups by random number table， with 36 cases in each group. Both groups of patients were treated with docetaxel combined with carboplatin. On this basis， the control group was treated with trastuzumab for 7 courses， while the observation group was treated with a dual targeted combination of trastuzumab and pertuzumab for 7 courses. Compare the clinical efficacy， serum levels of carbohydrate antigen 125 （CA-125） and carbohydrate antigen 153 （CA-153） before and after treatment， and adverse reactions during treatment between two groups of patients. Results  The effective rate of treatment in the observation group （80.55%） was significantly higher than that in the control group （50.00%）， and the difference between the groups was statistically significant （P<0.05）. Before treatment， there was no statistically significant difference in the serum levels of CA-125 and CA-153 between the two groups of patients （P>0.05）. After 7 courses of treatment， the serum levels of CA-125 and CA-153 in both groups of patients decreased， but the observation group was lower than the control group， and the difference was statistically significant （P<0.05）. During the treatment period， the incidence of adverse reactions in the control group was 11.11%， lower than the observation group's 13.89%， but there was no statistically significant difference between the groups （P>0.05）. Conclusion For HER-2 positive breast cancer， the dual targeted combination chemotherapy of trastuzumab and patouzumab has a good therapeutic effect， significantly reducing the levels of serum CA-125 and CA-153， while not increasing the incidence of adverse reactions.

【Key words】  Human epidermal growth factor receptor 2; Breast cancer; Chemotherapy; Trastuzumab; Patuzumab

乳腺癌是女性最常见的恶性肿瘤之一，好发于30～50岁人群[1]。在乳腺癌群体中，10%～20%的患者表现为人表皮生长因子受体2（HER-2）阳性，HER-2阳性乳腺癌患者的恶性程度高，常表现出较差的预后[2]。而因为乳腺癌的早期症状不典型，所以一旦确诊往往处在中晚期阶段，此时患者失去手术治疗机会，临床中多是采取放化疗以控制患者病情以及延长患者生存时间[3]。……