目的 探討烏苯美司聯(lián)合XEC化療方案治療三陰性乳腺癌患者的臨床療效及其對外周血T淋巴細(xì)胞亞群及血清骨橋蛋白（OPN）水平變化的影響。方法 選取河南科技大學(xué)第一附屬醫(yī)院2015年6月—2017年1月收治的三陰性乳腺癌患者83例，隨機分成對照組（41例）和治療組（42例）。對照組患者給予XEC化療方案治療，第1天靜脈滴注注射用環(huán)磷酰胺500 mg/m²，同時靜脈滴注注射用鹽酸表柔比星100 mg/m²，第1～14天口服卡培他濱片1 g/m²，療程為21 d。治療組在對照組的基礎(chǔ)上口服烏苯美司片，30 mg/次，1次/d，療程為21 d。兩組均持續(xù)治療4個療程。觀察兩組患者臨床療效，比較治療前后兩組患者SF-36評分、外周血T淋巴細(xì)胞亞群表達(dá)水平和OPN水平。結(jié)果 治療后，對照組和治療組臨床總有效率分別為75.61%、95.24%，兩組比較差異具有統(tǒng)計學(xué)意義（P<0.05）。治療后，兩組軀體疼痛、軀體功能、睡眠質(zhì)量、生命活力、生理職能、心理健康等生活質(zhì)量評分均顯著升高，同組治療前后比較差異具有統(tǒng)計學(xué)意義（P<0.05）；且治療后治療組生活質(zhì)量評分顯著高于對照組，兩組比較差異具有統(tǒng)計學(xué)意義（P<0.05）。治療后，兩組患者CD^3＋、CD^4＋、CD^4＋/CD^8＋水平均顯著升高，CD^8＋水平顯著下降，同組治療前后比較差異具有統(tǒng)計學(xué)意義（P<0.05）；且治療組T淋巴細(xì)胞亞群水平顯著優(yōu)于對照組，兩組比較差異具有統(tǒng)計學(xué)意義（P<0.05）。治療后，兩組血清OPN水平顯著下降，同組治療前后比較差異具有統(tǒng)計學(xué)意義（P<0.05）；且治療組血清OPN水平顯著低于對照組，兩組比較差異具有統(tǒng)計學(xué)意義（P<0.05）。結(jié)論 烏苯美司聯(lián)合XEC化療方案治療三陰性乳腺癌患者效果顯著，可有效改善患者外周血T淋巴細(xì)胞亞群和血清OPN水平，且安全性較高，具有一定的臨床推廣應(yīng)用價值。

Objective To investigate clinical effects of ubenimex combined with XEC chemotherapy in treatment of triple negative breast cancer, and study the influence on peripheral blood T lymphocyte subsets and serum OPN levels. Methods Patients (83 cases) with triple negative breast cancer in the First Affiliated Hospital of Henan University of Science and Technology from June 2015 to January 2017 were randomly divided into control (41 cases) and treatment (42 cases) groups. Patients in the control group were administered with XEC chemotherapy, they were iv administered with Cyclophosphamide for injection 500 mg/m² and Epirubicin Hydrochloride for injection 100 mg/m² on the first day, and they were po administered with Capecitabine Tablets 1 g/m² on 1-14 d. A course of treatment was 21 d. Patients in the treatment group were po administered with Ubenimex Capsules on the basis of the control group, 30 mg/time, once daily, and a course of treatment was 21 d. Patients in two groups were treated for 4 courses. After treatment, the clinical efficacy was evaluated, and the SF-36 score, T lymphocytes subset in peripheral blood, and OPN levels in two groups before and after treatment were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 75.61% and 95.24%, respectively, and there were differences between two groups (P < 0.05). After treatment, the indicators of body pain, physical function, sleep quality, life vitality, role physical, and mental health scores in two groups were significantly increased, and the difference was statistically significant in the same group (P < 0.05). And these scores in the treatment group were obviously higher than those in the control group, with significant difference between two groups (P < 0.05). After treatment, the CD³⁺, CD⁴⁺ and CD⁴⁺/CD⁸⁺ levels in two groups were significantly increased, but CD⁸⁺ level was significantly decreased, and the difference was statistically significant in the same group (P < 0.05). And the T lymphocytes subset in peripheral blood levels in the treatment group were more significantly better than those in the control group, with significant difference between two groups (P < 0.05). After treatment, the serum OPN levels in two groups were significantly decreased, and the difference was statistically significant in the same group (P < 0.05). And the serum OPN levels in the treatment group were significantly lower than those in the control group, with significant difference between two groups (P < 0.05). Conclusion Ubenimex combined with XEC chemotherapy has good effect in treatment of triple negative breast cancer, and can effectively improve the peripheral blood T lymphocyte subsets and serum OPN levels with higher safety, which has a certain clinical application value.

河南省醫(yī)學(xué)科技攻關(guān)計劃項目（201503188）