脂质体紫杉醇联合卡培他滨对晚期乳腺癌患者DBC1及SIRT1表达的影响-东南大学学报医学版

脂质体紫杉醇联合卡培他滨对晚期乳腺癌患者DBC1及SIRT1表达的影响

单位：1. 安徽省亳州市人民医院, 安徽亳州 236800;
2. 安徽医科大学第一附属医院普外科, 安徽合肥 230000

分类号：R737.9

出版年·卷·期（页码）：2016·35·第六期（961-964）

摘要：

目的：探讨脂质体紫杉醇联合卡培他滨对晚期乳腺癌患者干预后患者组织中DBC1及SIRT1的表达情况，为患者预后评价提供理论依据。方法：选取2013年7月至2015年7月收治的80例晚期乳腺癌患者作为研究对象，使用脂质体紫杉醇（力朴素）联合卡培他滨进行治疗，患者第1天使用135~175 mg·m^-2力朴素，然后每天使用2 000 mg·m^-2卡培他滨进行治疗，以21 d为1个疗程，患者连续治疗2~6个疗程后对疗效进行评价。比较脂质体紫杉醇联合卡培他滨干预前后患者病灶组织中SIRT1和DBC1表达水平差异，并分析不同病理类型中SIRT1及DBC1的表达差异，记录患者使用药物干预后不良反应发生情况。结果：治疗后患者SIRT1及DBC1表达阳性率均明显低于治疗前，差异具有统计学意义（χ²=65.83，P=0.000；χ²=53.43，P=0.000）；经治疗后不同病理类型患者的病灶组织中SIRT1和DBC1表达的阳性指数差异无统计学意义（P>0.05）；患者所出现的均为可逆性不良反应，大多数表现为以Ⅰ级或Ⅱ级不良反应为主的血液学毒性，其次为手足综合征和消化道反应，采取相应的对症治疗后均可依照原定计划完成化疗，并未出现明显的肝肾功能损伤及过敏反应。结论：对晚期乳腺癌患者使用脂质体紫杉醇联合卡培他滨干预后可显著降低其DBC1和SIRT1的阳性表达，且具有较好的安全性。

Objective: To investigate the expression of DBC1 and SIRT1 in advanced breast cancer patients treated by paclitaxel liposome combined with capecitabine, and to provide theoretical basis for the prognosis evaluation. Methods: 80 cases with advanced breast cancer treated in our hospital between July 2013 and July 2015 were chosen as research subjects. Patients were treated with paclitaxel liposome and capecitabine, first day patients were treated with 135-175 mg·m^-2 paclitaxel liposome, after that they were treated with capecitabine 2 000 mg·m^-2, 21 days as a course of treatment. After treated with 2-6 courses, the expression levels of SIRT1 and DBC1 in the lesions of the patients and in different pathological types were compared, and the adverse reactions were recorded. Results: After treatment the positive rates of SIRT1 and DBC1 expression were significantly lower than before treatment, and the difference was statistically significant(χ²=65.83, P=0.000; χ²=53.43, P=0.000). There was no significant difference in the expression of SIRT1 and DBC1 in different pathological tissues after treatment(P>0.05). The reversible adverse reactions were grade Ⅰ and Ⅱ of hematologic toxicity, hand foot syndrome and digestive tract reaction. By taken the corresponding symptomatic treatment they could be completed in accordance with the original plan chemotherapy, and did not show the liver and kidney function damage and allergic reaction. Conclusion: Patients with advanced breast cancer treated by paclitaxel liposome combined with capecitabine can significantly reduce the positive expression of DBC1 and SIRT1, and has a better security.

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