肿瘤相关炎性因子对曲妥珠单抗治疗HER2阳性转移性乳腺癌预后及疗效的影响

目的 研究肿瘤相关炎性因子(tumor associated inflammatory factor,TAIF)对曲妥珠单抗治疗人表皮生长因子受体2(HER2)阳性转移性乳腺癌(PMBC)预后及疗效的关系.方法 选取接受曲妥珠单抗方案治疗的HER2 PMBC患者89例纳入为试验组,选取同期接受健康体检的健康女性89例纳入为对照组,试验组所有患者均给予卡培他滨、吉西他滨联合曲妥珠单抗治疗,观察化疗前两组及试验组化疗前后的TNF-α、IL-1β、IL-6、IL-8水平,试验组的临床疗效,并对影响曲妥珠单抗治疗HER2 PMBC患者预后的因素进行多因素回归分析.结果治疗后,试验组的RR为40.45％,DCR为69.66％,1年内复发、转移率为79.78％.化疗前,试验组的TNF-α、IL-1β、IL-6、IL-8水平均明显高于对照组(P﹤0.01).试验组化疗前的TNF-α、IL-1β、IL-6、IL-8水平均明显高于化疗后(P﹤0.01).化疗前后,试验组1年内复发、转移患者的TNF-α、IL-1β、IL-6、IL-8水平均高于未复发、转移患者(P﹤0.05).年龄、身高、体重不是影响曲妥珠单抗治疗HER2 PMBC患者预后的危险因素(P﹥0.05);TNF-α、IL-1β、IL-6、IL-8是影响曲妥珠单抗治疗HER2 PMBC患者预后的危险因素(P﹤0.05).结论 TAIF可促进HER2 PMBC的进展、复发及转移,影响曲妥珠单抗治疗HER2 PMBC患者的疗效及预后.

Influence of tumor associated inflammatory factors on the prognosis and curative effect of HER2 positive metastatic breast cancer patients treated with trastuzumab

Objective To study the influence of tumor associated inflammatory factor (TAIF) on the prognosis and curative effect in HER2-positive metastatic breast cancer (HER2 PMBC) patients treated with trastuzumab. Method 89 cases of HER2 PMBC who were treated with trastuzumab (study group) and another 89 healthy females (control group) were included in the study, the patients in study group were given capecitabine, gemcitabine combined with trastuzumab, the level of TNF-α, IL-1β, IL-6, and IL-8 in control group and study group before and after chemotherapy were observed, besides, the clinical effect, and factors influencing the curative effect of trastuzumab in HER2 PMBC patients were ana-lyzed by multivariate regression analysis. Result After treatment, the response rate in study group was 40.45％, DCR was 69.66％, and 1-year recurrence/metastasis rate was 79.78％, before chemotherapy, the level of TNF-α, IL-1β, IL-6, and IL-8 in study group were significantly higher than those in control group (P<0.01), and were also higher than those af-ter chemotherapy in study group (P<0.01). The level of TNF-α, IL-1β, IL-6, and IL-8 in patients who had recurrence/me-tastasis in 1 year were higher than those without recurrence or metastasis both before and after chemotherapy (P<0.05). By multivariate analysis, it was found that, age, height, and weight were not of risk factors affecting the prognosis of pa-tients with HER2 PMBC who were treated with trastuzumab (P>0.05);instead, TNF-α, IL-1β, IL-6, IL-8 had marked in-fluence on the prognosis of these patients (P<0.05). Conclusion TAIF can promote the progression, recurrence and me-tastasis of HER2 PMBC, and affects the efficacy and prognosis in HER2 PMBC patients treated with trastuzumab.