A 57-year-old female presents with progressive nail changes. Her fingernails(手指甲) have yellow brown discoloration and distal onycholysis(甲脱离). She has metastatic breast cancer(转移性乳腺癌) and is on chemotherapy.
What is the mechanism of action of the chemotherapeutic agent that most likely accounts for her nail findings?
A. Epidermal growth factor inhibitor ( 表皮生长因子抑制剂)
B. Microtubule depolymerization inhibitor (微管解聚抑制剂)
C. RNA synthesis inhibitor (RNA合成抑制剂)
D. Proteasome inhibitor ( 蛋白酶体抑制剂)
答案解析:
紫杉烷类与多西他赛和紫杉醇一样,是微管解聚抑制剂,常用于晚期乳腺癌以及卵巢癌、肺癌和膀胱癌的治疗。紫杉烷诱导的指(趾)甲变化常见,表现多种多样,包括色素沉着和甲剥离(如该患者所示)以及甲脱落、Beau线、甲下出血、甲下脓肿、化脓性肉芽肿和甲沟炎。这些指(趾)甲异常可能显著影响功能和生活质量,并导致继发性感染、中性粒细胞减少和败血症等疾病。使用冷冻袜子和手套以及COX-2抑制剂进行局部冷却可能是有益的。
正确答案:B
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