中华医学杂志
中華醫學雜誌
중화의학잡지
National Medical Journal of China
2008年
14期
961-964
,共4页
乳腺肿瘤%新辅助化疗%完全病理性缓解
乳腺腫瘤%新輔助化療%完全病理性緩解
유선종류%신보조화료%완전병이성완해
Breast cancer%Neoadjuvant chemotherapy%Pathological complete response
目的 探讨乳腺癌新辅助化疗后肿瘤和腋淋巴结及结外软组织病理缓解的影响因素及与预后的关系.方法 选择2000年10月至2001年8月在天津肿瘤医院乳腺科接受新辅助化疗、化疗后手术的196例ⅡB～ⅢB期乳腺癌患者.观察肿瘤、腋淋巴结及结外软组织病理缓解的程度,分析影响病理缓解的因素,及病理缓解与预后的关系.随访率100%,中位随访期61个月(4～70个月).结果 新辅助化疗后肿瘤的病理完全缓解pCR20例(10.2%),病理部分缓解pPR108例(55.1%),病理无变化pSD68例(34.7%),27.0%的转移淋巴结降期.病理缓解率与患者年龄、临床分期无关(P＞0.05),与肿瘤大小、激素受体状况、病理类型相关(P＜0.01).5年总生存率62.8%(P＜0.01),中位生存期为61个月(P＜0.01).结论 病理缓解率与肿瘤大小、激素受体状况、病理类型相关.新辅助化疗后原发瘤和转移淋巴结的降期是重要的预后因素.
目的 探討乳腺癌新輔助化療後腫瘤和腋淋巴結及結外軟組織病理緩解的影響因素及與預後的關繫.方法 選擇2000年10月至2001年8月在天津腫瘤醫院乳腺科接受新輔助化療、化療後手術的196例ⅡB～ⅢB期乳腺癌患者.觀察腫瘤、腋淋巴結及結外軟組織病理緩解的程度,分析影響病理緩解的因素,及病理緩解與預後的關繫.隨訪率100%,中位隨訪期61箇月(4～70箇月).結果 新輔助化療後腫瘤的病理完全緩解pCR20例(10.2%),病理部分緩解pPR108例(55.1%),病理無變化pSD68例(34.7%),27.0%的轉移淋巴結降期.病理緩解率與患者年齡、臨床分期無關(P＞0.05),與腫瘤大小、激素受體狀況、病理類型相關(P＜0.01).5年總生存率62.8%(P＜0.01),中位生存期為61箇月(P＜0.01).結論 病理緩解率與腫瘤大小、激素受體狀況、病理類型相關.新輔助化療後原髮瘤和轉移淋巴結的降期是重要的預後因素.
목적 탐토유선암신보조화료후종류화액림파결급결외연조직병리완해적영향인소급여예후적관계.방법 선택2000년10월지2001년8월재천진종류의원유선과접수신보조화료、화료후수술적196례ⅡB～ⅢB기유선암환자.관찰종류、액림파결급결외연조직병리완해적정도,분석영향병리완해적인소,급병리완해여예후적관계.수방솔100%,중위수방기61개월(4～70개월).결과 신보조화료후종류적병리완전완해pCR20례(10.2%),병리부분완해pPR108례(55.1%),병리무변화pSD68례(34.7%),27.0%적전이림파결강기.병리완해솔여환자년령、림상분기무관(P＞0.05),여종류대소、격소수체상황、병리류형상관(P＜0.01).5년총생존솔62.8%(P＜0.01),중위생존기위61개월(P＜0.01).결론 병리완해솔여종류대소、격소수체상황、병리류형상관.신보조화료후원발류화전이림파결적강기시중요적예후인소.
Objective Discuss the influential factor of pathologic response of tumor, axillary lymph nodes and extranodal soft tissue extension(ETE)in breast cancer after neoadiuvant chemotherapy and patients survival. Methods 196 patients with Ⅱ B～ⅢB stage breast cancer, all female, aged 47(26-65), were treated by neoadjuvant chemotherapy, including intravenous injection of docetaxel and epirubiein for 21 days, followed by surgery. Then follow-up was conducted for 61 months(4-70 months). The influential factor of pathological response and relation between pathologic response and survival were analyzed. Resuits The follow-up rate of the 196 patients was 100%. 20 patients(10. 2%)achieved pathological complete response(pCR), 108 patients(55. 1%)achieved pathological part response(pPR), and 68 patients(34. 7%)achieved pathological stable disease pSD. There was no correlation between pCR and clinical staging, and age of patients(both P＞0. 05). But there was a correlation between pCR and the size of tumor, estrogen receptor(ER), progesterone receptor(PR), and pathological type(all P＜0. 01). 27. 0% of the metastatic axillary lymph-nodes showed down-staging. The overall 5-year survival rate was 62. 8%(P＜0. 01). The median period of survival was 61 month (P＜0. 01). Conclusion pCR is correlated with the size of tumor, ER, PR, and pathological type. Down-staging of primary tumor and metastatic axillary lymph-node are important prognosis factors.
