拉帕替尼联合微波热疗治疗HER2阳性晚期乳腺癌的疗效

目的 研究拉帕替尼联合微波热疗治疗人类表皮生长因子受体2（human epidermal growth factor receptor 2，HER2）阳性晚期乳腺癌患者的疗效。方法 选取2019年1月至2020年1月于湖州市中心医院就诊的HER2阳性晚期乳腺癌患者134例，根据抽签法将其分为对照组和观察组，每组各67例。两组均使用拉帕替尼治疗，观察组患者在此基础上联合微波热疗治疗。比较两组患者治疗前后的肿瘤标志物[糖类抗原153（carbohydrate antigen 153，CA153）、癌胚抗原（carcinoembryonic antigen，CEA）、组织多肽抗原（tissue peptide antigen，TPA）]、循环肿瘤细胞（circulating tumor cell，CTC）数量、波形蛋白表达和生存质量，统计两组患者的临床疗效及生存状态。结果 治疗后，两组患者的CA153、CEA、TPA、CTC数量、波形蛋白表达均显著低于本组治疗前，生存质量评分均显著高于本组治疗前（P<0.05）；观察组患者的CA153、CEA、TPA、CTC数量、波形蛋白表达均显著低于对照组，生存质量评分显著高于对照组（P<0.05）。观察组患者的治疗总有效率显著高于对照组（χ2=5.350，P=0.021）。两组患者的不良反应比较差异均无统计学意义（P>0.05）。随访24个月，观察组患者的总生存期、无进展生存期均显著长于对照组，24个月累积生存率显著高于对照组（P<0.05）。结论 拉帕替尼联合微波热疗治疗HER2阳性晚期乳腺癌效果良好，可改变波形蛋白表达抑制疾病进展，延长患者的生存期。

Efficacy of lapatinib combined with microwave hyperthermia in the treatment of HER2-positive advanced breast cancer

Objective To investigate the efficacy of lapatinib combined with microwave hyperthermia in the treatment of human epidermal growth factor receptor 2 (HER2) positive advanced breast cancer. Methods A total of 134 patients with HER2-positive advanced breast cancer treated in Huzhou Central Hospital from January 2019 to January 2020 were selected and divided into control group and observation group according to the lottery method, with 67 cases in each group. Both groups were treated with lapatinib, and the patients of observation group was treated with microwave hyperthermia on this basis. Tumor markers [carbohydrate antigen 153 (CA153), carcinoembryonic antigen (CEA), tissue peptide antigen (TPA)], the number of circulating tumor cells (CTC), vimentin expression and quality of life were compared between two groups before and after treatment. The clinical efficacy and survival status of two groups were analyzed. Results After treatment, CA153, CEA, TPA, the number of CTC and vimentin expression in two groups were significantly lower than before treatment, and the quality of life score was significantly higher than before treatment (P<0.05). CA153, CEA, TPA, the number of CTC and vimentin expression in observation group were significantly lower than those in control group, and the quality of life score was significantly higher than that in control group (P<0.05). The total effective rate of observation group was significantly higher than that of control group (χ2=5.350, P=0.021). There was no significant difference in adverse reactions between two groups (P>0.05). After 24 months of follow-up, the overall survival and progression-free survival of observation group were significantly longer than those of control group, and the 24-month cumulative survival rate was higher than that of control group (P<0.05). Conclusion Lapatinib combined with microwave hyperthermia has a good effect in the treatment of HER2-positive advanced breast cancer, which can change vimentin expression, inhibit disease progression and prolong the survival of patients.