短期新辅助内分泌治疗后肿瘤学指标变化预测HR阳性乳腺癌治疗效果的研究

杨翼鹏　胡泓　周文斌　陈观玲　周冬仙

【摘要】 目的：探討短期新辅助内分泌治疗（NHT）后肿瘤学指标变化预测HR阳性乳腺癌治疗效果的应用价值。方法：选取2018年1月-2019年7月笔者所在医院收治的100例HR阳性乳腺癌患者，均接受NHT治疗。检测患者治疗前后肿瘤学指标癌胚抗原（CEA）、血清糖类抗原125（CA125）、CA153水平变化，分析不同疗效患者治疗前后CEA、CA125、CA153水平变化。结果：治疗后100例HR阳性乳腺癌中完全缓解（CR）9例，部分缓解（PR）46例，疾病稳定（SD）33例，疾病进展（PD）12例，治疗有效率为55.00%（55/100）。CR+PR患者治疗前CEA、CA125、CA153水平均高于SD及PD患者（P<0.05）;SD与PD患者治疗前CEA、CA125、CA153水平比较差异均无统计学意义（P>0.05）;治疗后CR+PR患者CEA、CA125、CA153水平均较治疗前显著降低，PD患者CA153水平较治疗前显著升高（P<0.05）;治疗后SD患者CEA、CA125、CA153水平与治疗前比较差异无统计学意义（P>0.05）。治疗后PD患者CEA、CA125水平与治疗前比较差异无统计学意义（P>0.05）。CR+PR患者CEA、CA125、CA153水平治疗前后差值高于SD及PD患者（P<0.05）。结论：CEA、CA125、CA153水平对HR阳性乳腺癌NHT治疗效果有较好的预测价值。

【关键词】 短期新辅助内分泌治疗 肿瘤学指标 预测 HR阳性乳腺癌 临床研究

doi：10.14033/j.cnki.cfmr.2020.18.023 文献标识码 B 文章编号 1674-6805（2020）18-00-03

Study on the Changes of Oncology Indexes after Short-term Neoadjuvant Hormone Therapy in Predicting the Therapeutic Effect of HR-Positive Breast Cancer/YANG Yipeng， HU Hong， ZHOU Wenbin， CHEN Guanling， ZHOU Dongxian. //Chinese and Foreign Medical Research， 2020， 18（18）： -56

[Abstract] Objective： To evaluate the application value of oncology indexes after short-term neoadjuvant hormone therapy （NHT） in predicting the therapeutic effect of HR-positive breast cancer. Method： A total of 100 patients with HR-positive breast cancer admitted in our hospital from January 2018 to July 2019 were selected， and all received NHT treatment. The changes of cancer embryonic antigen （CEA）， serum carbohydrate antigen 125 （CA125）， and CA153 were detected before and after treatment. The changes of CEA， CA125， and CA153 levels before and after treatment were analyzed in patients with different curative effects. Result： Among the 100 patients with HR-positive breast cancer after treatment， there were 9 cases with complete response （CR）， 46 cases with partial response （PR）， 33 cases with stable disease （SD）， and 12 cases with disease progression （PD）. The effective rate of treatment was 55.00% （55/100）. Before treatment， CEA， CA125 and CA153 levels of CR+PR patients were higher than those of SD and PD patients （P<0.05）. There were no significant differences in CEA， CA125 and CA153 levels between SD and PD patients before treatment （P>0.05）. After treatment， the levels of CEA， CA125 and CA153 in CR+PR patients were significantly lower than those before treatment， and the levels of CA153 in PD patients were significantly higher than that before treatment （P<0.05）. There was no significant difference in CEA， CA125 and CA153 levels between SD patients after treatment and before treatment （P>0.05）. There was no significant difference in CEA and CA125 levels between PD patients after treatment and before treatment （P>0.05）. The difference value of CEA， CA125， and CA153 levels in CR+PR patients before and after treatment were higher than those in SD and PD patients （P<0.05）. Conclusion： The levels of CEA， CA125， and CA153 have good predictive value for the therapeutic effect of NHT therapy in HR-positive breast cancer.

[Key words] Short-term neoadjuvant hormone therapy Oncological indexes Prediction HR-positive breast cancer Clinical research

First-authors address： Shenzhen Peoples Hospital， Shenzhen 518020， China

短期新辅助内分泌治疗（neoadjuvant hormone therapy，NHT）可有效缩小肿瘤，提高保乳率、明确肿瘤生物学特性，对不适合化疗或者手术的激素受体（hormone receptor，HR）阳性乳腺癌患者来说是一个合适的治疗选择[1-2]。许多临床研究表明，NHT在选择性乳腺癌患者中应用是安全有效的[3-4]。然而，NHT的临床应用仍存在某些争议，如对NHT治疗不敏感者行NHT是否会延误治疗，核芯针穿刺获取病理结果过程中可能会造成肿瘤种植与播散，以及NHT治疗是否可能会打击患者免疫力，增加手术风险等[5-6]。因此，提前预测患者NHT治疗效果对制定治疗方案提高治疗质量具有重要意义。据报道，多种肿瘤学指标与肿瘤患者预后有显著联系，由此提示血清肿瘤标志物水平有助于评价治疗效果及预测肿瘤复发[7]。本研……