TCH新辅助化疗方案对HER2阳性乳腺癌的疗效及对患者ER、PR、HER2表达的影响

温润耀

【摘要】 目的：探討TCH新辅助化疗方案对人表皮生长因子受体2（HER2）阳性乳腺癌的疗效及对患者ER、PR、HER2表达的影响。方法：选择2019年1月-2020年3月在本院进行治疗的78例乳腺癌患者。按照随机数字表法将患者分为观察组和对照组，每组39例。对照组接受TAC方案，观察组接受TCH方案。比较两组患者的疗效、FACT-B评分、不良反应发生情况。结果：观察组干预后ER、PR水平均高于干预前和对照组，Ki-67、HER2、CEA、CA15-3水平均低于干预前和对照组，差异均有统计学意义（P<0.05）。观察组干预后TGF-β1、VEGF水平均低于干预前和对照组，差异均有统计学意义（P<0.05）。观察组总有效率为97.44%，高于对照组的76.92%，差异有统计学意义（P<0.05）。治疗后，两组FACT-B评分均高于治疗前，且观察组高于对照组，差异均有统计学意义（P<0.05）。观察组不良反应发生率为7.69%，低于对照组的25.64%，差异有统计学意义（P<0.05）。结论：TCH新辅助化疗方案治疗HER2阳性乳腺癌疗效显著，能够促进HER2下降和ER、PR升高，且安全性良好。

【关键词】 HER2阳性乳腺癌 TCH新辅助化疗 ER PR

Influence of Efficacy and Levels of ER， PR， HER2 in HER2 Positive Breast Cancer by TCH Neoadjuvant Chemotherapy Regimen/WEN Runyao. //Medical Innovation of China， 2021， 18（13）： 0-019

[Abstract] Objective： To investigate the efficacy of TCH neoadjuvant chemotherapy regimen on human epidermal growth factor receptor 2 （HER2） positive breast cancer and its effect on ER， PR and HER2 expression in patients. Method： A total of 78 patients with breast cancer who received treatment in our hospital from January 2019 to March 2020 were selected. According to random number table method， the patients were divided into observation group and control group， 39 cases in each group. The control group received TAC regimen， and the observation group received TCH regimen. The efficacy， FACT-B score and the incidence of ADR were compared between the two groups. Result： After intervention， the levels of ER and PR in the observation group were higher than those of before intervention and the control group， and the levels of Ki-67， HER2， CEA and CA15-3 in the observation group were lower than those of before intervention and the control group， the differences were statistically significant （P<0.05）. The levels of TGF-β1 and VEGF in the observation group after intervention were lower than those before intervention and control group， the differences were statistically significant （P<0.05）. The total effective rate of the observation group was 97.44%， which was higher than 76.92% of the control group， the difference was statistically significant （P<0.05）. After treatment， FACT-B scores of both groups were higher than before treatment， and observation group was higher than control group， the differences were statistically significant （P<0.05）. The incidence of ADR in the observation group was 7.69%， which was lower than 25.64% in the control group， the difference was statistically significant （P<0.05）. Conclusion： The TCH neoadjuvant chemotherapy regimen has significant efficacy in the treatment of breast cancer with positive HER2， and can promote the decrease of HER2 and the increase of ER and PR， with good safety.

[Key words] HER2 positive breast cancer TCH neoadjuvant chemotherapy ER PR

First-authors address： Dongguan Peoples Hospital， Dongguan 523059， China

doi：10.3969/j.issn.1674-4985.2021.13.004

乳腺癌在女性中有着比较高的发病率，属于恶性肿瘤之一，转移率和死亡率均较高的，该疾病的发生发展严重威胁者女性健康。人表皮生长因子受体2（HER2）阳性乳腺癌作为一种特殊疾病，为乳腺癌的常见类型，恶性程度和侵袭性均高于其他类型乳腺癌，目前主要采取化疗进行治疗[1]。近几年，TCH新辅助化疗在该疾病治疗中的效果逐渐得到了临床医师的认可，化疗敏感性较好[2]。随着国外对于HER2阳性乳腺癌发病机制研究的不断深入，有报道指出雌激素受体（ER）以及HER2均在该病的发病中发挥着重要作用，经过化疗后也会出现明显的改变，但国内对此研究较少[3-4]。本研究即对这一方案与常规TAC方案治疗效果差异及对ER、PR、HER2等的影响进行分析。现报道如下。

1 资料与方法

1.1 一般资料 选择2019年1月-2020年3月在本院进行治疗的78例乳腺癌患者。（1）纳入标准：符合乳腺癌诊断标准[5]，经病理检查和免疫组化染色检查明确为HER2阳性乳腺癌;初次确诊，入选前未接受过任何方案化疗治疗;TNM分期为Ⅱ～Ⅲ期;预计生存期>6个月;均为女性。（……