【摘要】 目的探讨鸦胆子油乳联合新辅助化疗治疗局部晚期乳腺癌(LABC)的疗效及对病灶内乳腺癌相关增殖、侵袭基因表达的影响。方法 2016年1月至2018年1月间至凉山彝族自治州第一人民医院进行乳腺癌根治术治疗的LABC患者119例,回顾性分析术前保守治疗方案并将其分为两组:对照组61例,采用术前接受新辅助化疗;鸦胆子油乳组58例,采用术前接受鸦胆子油乳联合新辅助化疗。比较两组患者的近期疗效以及术中病灶组织中乳腺癌相关增殖基因、侵袭基因表达量的差异,记录保守治疗期间药物不良反应的发生情况。结果化疗4周期后,鸦胆子油乳组患者的总有效率91. 38%,高于对照组患者的77. 05%(P <0. 05)。鸦胆子油乳组患者术中病灶组织中增殖基因BCYRN1、GP73、SIAH2、STIMI mRNA的表达量低于对照组患者,侵袭基因TMEM158、Wnt1 mRNA的表达量低于对照组患者,RSK4m1、PDK4 mRNA的表达量高于对照组患者(P <0. 05)。治疗期间,鸦胆子油乳组患者的骨髓抑制发生率低于对照组患者(P <0. 05),两组间恶心呕吐、口腔黏膜炎、过敏性休克、肝肾功能损害等不良反应发生率的差异无统计学意义(P> 0. 05)。结论 LABC患者接受鸦胆子油乳联合新辅助化疗,可有效提升近期疗效并降低增殖基因表达量,抑制侵袭活力,且有助于减少骨髓抑制等药物不良反应的发生,是一种高效安全的治疗方案。更多还原

【Abstract】 Objective To investigate the efficacy of Brucea javanica oil emulsion combined with neoadjuvant chemotherapy on locally advanced breast cancer(LABC) and their influences on expression of breast cancer-associated proliferation and invasion genes.Methods 119 cases of LABC patients in The First People’s Hospital of Liangshan Yi Autonomous Prefecture from January 2016 to January 2018 underwent radical mastectomy were chosen as research subjects,all patients were divided into control group(n=61,underwent preoperative neoadjuvant chemotherapy),bruceolic oil emulsion group(n=58,underwent preoperative bruceolic oil emulsion combined with neoadjuvant chemotherapy).The short-term efficacy and expression of breast cancer-associated proliferative genes and invasive genes were compared between two groups,and the occurrence of adverse drug reactions during conservative treatment were recorded.Results After 4 cycles of chemotherapy,OR level in bruceolic oil emulsion group(91.38%) was higher than that in control group(77.05%)(P<0.05).Expression of proliferative genes such as BCYRN1,GP73,SIAH2 and STIMI mRNA in lesions of bruceolic oil emulsion group were lower than those of control group,expression of invasive genes such as TMEM158,Wnt1 mRNA were lower than those of control group,and expression of RSK4 m1 and PDK4 mRNA were higher than those of control group(P<0.05).The incidence of myelosuppression in bruceolic oil emulsion group was lower than that in control group(P<0.05).There were no significant difference in incidences of nausea and vomiting,oral mucositis,anaphylactic shock,liver and kidney dysfunction between two groups(P>0.05).Conclusion Bruceolic oil emulsion combines with neoadjuvant chemotherapy in LABC patients can effectively improve short-term efficacy and reduce the expression of proliferating genes and inhibit the invasive activity,help to reduce the incidence of adverse drug reactions such as bone marrow suppression,is a highly effective and safe treatment.更多还原