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丙型肝炎病毒感染对乳腺癌患者化疗安全性的影响。

Effects of hepatitis C virus infection on the safety of chemotherapy for breast cancer patients.

机构信息

Department of Thyroid and Breast Surgery, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China.

Department of Infectious Diseases, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China.

出版信息

Breast Cancer Res Treat. 2017 Jul;164(2):379-383. doi: 10.1007/s10549-017-4259-8. Epub 2017 Apr 26.

Abstract

PURPOSE

Hepatitis C virus (HCV) is one of the major pathogens of chronic viral hepatitis, and approximately 38 million patients are infected with HCV in China. However, little information is available on the effect of HCV infection during chemotherapy for breast cancer and the impact of HCV infection on the toxicity of chemotherapy and targeted therapy.

METHODS

We performed a retrospective survey of 835 patients who were diagnosed with breast cancer between January 2010 and December 2015 at our institution. All patients had been screened for HCV infection at the time of breast cancer diagnosis. We retrospectively investigated the toxicities of chemotherapy and the changes in HCV load based on a review of the medical records.

RESULTS

A total of 21 patients with positive anti-HCV antibody tests received chemotherapy. The median patient age was 46.3 ± 11.2 years. Four (19.0%) patients exhibited abnormal liver function at baseline. The morbidity of abnormal liver function at baseline was higher in HCV-infected patients (19.0% vs. 0, P = 0.000). Four patients received trastuzumab therapy. Five (23.8%) patients who received chemotherapy developed hepatitis. No patients presented with HCV reactivation. The morbidity of hepatitis and the rate of disruption of chemotherapy were not significantly different between breast cancer patients without HCV infection and those with HCV infection (23.8 vs. 14.2% P = 0.342, 9.5 vs. 5.0% P = 0.619, respectively).

CONCLUSION

HCV infection had no adverse impact on chemotherapy in breast cancer patients. However, consulting a gastroenterologist and closely monitoring liver function during the course of chemotherapy may benefit patients.

摘要

目的

丙型肝炎病毒(HCV)是慢性病毒性肝炎的主要病原体之一,中国约有 3800 万 HCV 感染者。然而,有关 HCV 感染对乳腺癌化疗的影响以及 HCV 感染对化疗和靶向治疗毒性的影响的信息甚少。

方法

我们对 2010 年 1 月至 2015 年 12 月在我院诊断为乳腺癌的 835 例患者进行了回顾性调查。所有患者在乳腺癌诊断时均接受了 HCV 感染筛查。我们通过回顾病历,调查了化疗毒性和 HCV 载量变化。

结果

共有 21 例抗 HCV 抗体阳性患者接受了化疗。中位患者年龄为 46.3±11.2 岁。4 例(19.0%)患者基线时肝功能异常。HCV 感染者基线时肝功能异常的发病率较高(19.0%比 0,P=0.000)。4 例患者接受曲妥珠单抗治疗。5 例(23.8%)接受化疗的患者发生肝炎。无患者出现 HCV 再激活。无 HCV 感染的乳腺癌患者与 HCV 感染的患者相比,肝炎的发病率和化疗中断率无显著差异(23.8%比 14.2%,P=0.342;9.5%比 5.0%,P=0.619)。

结论

HCV 感染对乳腺癌患者的化疗无不良影响。然而,在化疗过程中咨询消化科医生并密切监测肝功能可能对患者有益。

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