乳腺癌患者术后化学治疗相关认知障碍与炎性细胞因子白细胞介素1、6和肿瘤坏死因子-α的相关性
发布时间：2018-07-27 21:05
【摘要】：目的研究不同化学治疗方案对乳腺癌患者认知功能的影响,以及炎性细胞因子水平变化与患者认知功能变化之间的相关性。方法选取87例接受术后EC-T方案(表柔比星、环磷酰胺序贯多西他赛,28例)、FEC方案(表柔比星、氟尿嘧啶、环磷酰胺,31例)和TC方案(多西他赛、环磷酰胺,28例)化学治疗的早期乳腺癌患者,EC-T方案8个疗程、FEC方案6个疗程、TC方案4个疗程,每个疗程均为21d。患者在化学治疗开始前3d(治疗前)、全部疗程结束后3d(治疗后)分别应用简易精神状态量表(MMSE)和中文听觉词语学习测验(AVLT)进行认知功能检查,同时检测血浆炎性细胞因子IL-1、IL-6、TNF-α水平。结果接受EC-T方案治疗的患者治疗后血浆IL-1和IL-6水平升高幅度显著大于其他两种治疗方案(P值均0.01),接受TC方案治疗的患者治疗后血浆IL-1和TNF-α水平升高幅度均显著小于其他两种治疗方案(P值均0.01)。接受EC-T方案治疗的患者治疗后MMSE评分和AVLT平均得分的降低幅度均显著大于其他两种治疗方案(P值均0.01)。患者治疗前后血浆IL-1和TNF-α水平变化与AVLT平均得分变化呈负相关(相关系数分别为-0.581和-0.303,P值均0.01),治疗前后血浆IL-6水平变化与AVLT平均得分变化不相关(P=0.07)。结论乳腺癌患者术后接受化学治疗后血浆炎性细胞因子IL-1、IL-6和TNF-α水平较化学治疗前出现不同程度升高,认知功能出现下降。相比于FEC方案和TC方案,EC-T方案治疗后IL-1、IL-6、TNF-α水平升高最为明显,MMSE评分和AVTL平均得分降低最多。治疗前后血浆IL-1和TNF-α水平变化与AVLT平均得分变化呈负相关。
[Abstract]:Objective to study the effects of different chemotherapy regimens on cognitive function of breast cancer patients and the correlation between the level of inflammatory cytokines and the cognitive function of breast cancer patients. Methods Eighty-seven patients received EC-T regimen (epirubicin, cyclophosphamide sequential docetaxel, 28 cases) and TC regimen (docetaxel) (epirubicin, fluorouracil, cyclophosphamide in 31 cases). 28 patients with early breast cancer treated with cyclophosphamide) were treated with EC-T regimen for 8 courses and FEC regimen for 6 courses and TC regimen for 4 courses, each course was 21 days. The cognitive function of the patients was examined 3 days before chemotherapy and 3 days after the complete course of treatment with (MMSE) and (AVLT) respectively, and the level of plasma inflammatory cytokine IL-1IL-6 TNF- 伪 was measured. Results the plasma levels of IL-1 and IL-6 in patients treated with EC-T regimen were significantly higher than those in the other two groups (P < 0.01). The levels of plasma IL-1 and TNF- 伪 in patients treated with TC regimen were significantly higher than those in patients treated with TC regimen (P < 0.01). In the other two treatment schemes (P value 0.01). The decrease of MMSE score and average AVLT score in patients receiving EC-T regimen were significantly higher than those in the other two groups (P < 0. 01). The changes of plasma IL-1 and TNF- 伪 levels were negatively correlated with the mean score of AVLT before and after treatment (correlation coefficients were -0.581 and -0.303, respectively, P < 0.01). There was no correlation between the changes of plasma IL-6 levels and the mean AVLT scores before and after treatment (P0. 07). Conclusion the levels of plasma inflammatory cytokines IL 1, IL 6 and TNF- 伪 in patients with breast cancer after chemotherapy were higher than those before chemotherapy, and cognitive function was decreased. Compared with FEC regimen and TC regimen EC-T regimen, the level of IL-1mMSE / TNF- 伪 increased most significantly and the average score of AVTL decreased most significantly. Plasma IL-1 and TNF- 伪 levels were negatively correlated with the mean AVLT score before and after treatment.
【作者单位】： 同济大学附属杨浦医院乳腺外科;同济大学附属杨浦医院检验科;
【基金】：同济大学附属杨浦医院科研资助项目(Se201522)
【分类号】：R737.9
[Abstract]:Objective to study the effects of different chemotherapy regimens on cognitive function of breast cancer patients and the correlation between the level of inflammatory cytokines and the cognitive function of breast cancer patients. Methods Eighty-seven patients received EC-T regimen (epirubicin, cyclophosphamide sequential docetaxel, 28 cases) and TC regimen (docetaxel) (epirubicin, fluorouracil, cyclophosphamide in 31 cases). 28 patients with early breast cancer treated with cyclophosphamide) were treated with EC-T regimen for 8 courses and FEC regimen for 6 courses and TC regimen for 4 courses, each course was 21 days. The cognitive function of the patients was examined 3 days before chemotherapy and 3 days after the complete course of treatment with (MMSE) and (AVLT) respectively, and the level of plasma inflammatory cytokine IL-1IL-6 TNF- 伪 was measured. Results the plasma levels of IL-1 and IL-6 in patients treated with EC-T regimen were significantly higher than those in the other two groups (P < 0.01). The levels of plasma IL-1 and TNF- 伪 in patients treated with TC regimen were significantly higher than those in patients treated with TC regimen (P < 0.01). In the other two treatment schemes (P value 0.01). The decrease of MMSE score and average AVLT score in patients receiving EC-T regimen were significantly higher than those in the other two groups (P < 0. 01). The changes of plasma IL-1 and TNF- 伪 levels were negatively correlated with the mean score of AVLT before and after treatment (correlation coefficients were -0.581 and -0.303, respectively, P < 0.01). There was no correlation between the changes of plasma IL-6 levels and the mean AVLT scores before and after treatment (P0. 07). Conclusion the levels of plasma inflammatory cytokines IL 1, IL 6 and TNF- 伪 in patients with breast cancer after chemotherapy were higher than those before chemotherapy, and cognitive function was decreased. Compared with FEC regimen and TC regimen EC-T regimen, the level of IL-1mMSE / TNF- 伪 increased most significantly and the average score of AVTL decreased most significantly. Plasma IL-1 and TNF- 伪 levels were negatively correlated with the mean AVLT score before and after treatment.
【作者单位】： 同济大学附属杨浦医院乳腺外科;同济大学附属杨浦医院检验科;
【基金】：同济大学附属杨浦医院科研资助项目(Se201522)
【分类号】：R737.9
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