CAJ | 학술논문

目的：探讨新辅助化疗（ NACT）后雌激素受体（ ER）、孕激素受体（ PR）由阴转阳乳腺癌患者内分泌治疗的临床疗效。方法78例乳腺癌新辅助化疗后ER、PR由阴转阳患者，按随机数字表法分为内分泌治疗组42例及传统治疗组36例。内分泌治疗组在术后口服三苯氧胺10 mg/次，2次/d；传统治疗组术后不予内分泌治疗。观察两组患者的随访效果并对两组的3年、5年生存率和总生存率进行比较。结果内分泌治疗组复发转移16例（38．1％），各种原因死亡11例（26．2％）；传统治疗组复发转移22例（61．1％），各种原因死亡18例（50．0％），内分泌治疗组的复发转移率、死亡率均低于传统治疗组（P均＜0．05）；内分泌治疗组的3年、5年无病生存率分别为73．8％（31/42）、61．9％（26/42），总生存率分别为83．3％（35/42）、73．8％（31/42）；传统治疗组3年、5年无病生存率分别为50．0％（18/36）、38．9％（14/36），总生存率分别为61．1％（22/36）、50．0％（18/36）。内分泌治疗组3年、5年无病生存率及总生存率均高于传统治疗组（ P均＜0．05）。结论内分泌治疗可有效地提高新辅助化疗后ER、PR由阴转阳的乳腺癌患者的生存率，降低复发转移率及死亡率。
목적：탐토신보조화료（ NACT）후자격소수체（ ER）、잉격소수체（ PR）유음전양유선암환자내분비치료적림상료효。방법78례유선암신보조화료후ER、PR유음전양환자，안수궤수자표법분위내분비치료조42례급전통치료조36례。내분비치료조재술후구복삼분양알10 mg/차，2차/d；전통치료조술후불여내분비치료。관찰량조환자적수방효과병대량조적3년、5년생존솔화총생존솔진행비교。결과내분비치료조복발전이16례（38．1％），각충원인사망11례（26．2％）；전통치료조복발전이22례（61．1％），각충원인사망18례（50．0％），내분비치료조적복발전이솔、사망솔균저우전통치료조（P균＜0．05）；내분비치료조적3년、5년무병생존솔분별위73．8％（31/42）、61．9％（26/42），총생존솔분별위83．3％（35/42）、73．8％（31/42）；전통치료조3년、5년무병생존솔분별위50．0％（18/36）、38．9％（14/36），총생존솔분별위61．1％（22/36）、50．0％（18/36）。내분비치료조3년、5년무병생존솔급총생존솔균고우전통치료조（ P균＜0．05）。결론내분비치료가유효지제고신보조화료후ER、PR유음전양적유선암환자적생존솔，강저복발전이솔급사망솔。
Objective To study the curative effect of endocrine therapy on the treatment of breast cancer patients with estrogen receptor(ER),progesterone receptor(PR) from negative to positive after neoadjuvant chemotherapy (NACT). Methods Seventy-eight breast cancer patients with ER ,PR from negative to positive after NACT were randomly divided into the endocrine therapy group of 42 cases and the traditional treatment group of 36 cases according to the random number table.The patients in the endocrine therapy group were given oral tamoxifen after operation (10 mg/time,2 times/d),while the patients in the traditional treatment group didn′t recieved endocrine therapy after operation .The curative effects of patients in two groups were observed ,and the 3-,5-year survivals and total survivals of two group were compared .Results There were 16 cases(38.1%) of recurrence/metastasis and 11 cases(26.2%) of various causes of death in the endocrine therapy group,while 22 cases(61.1%) of recurrence/metastasis and 18 cases(50.0%) of various causes of death in the traditional treatment group,the recurrence/metastasis rate,mortality of endocrine therapy group were lower than those of traditional treatment group (all P<0.05).The 3-,5-year disease-free survivals(DFS) of endocrine therapy group were 73.8%(31/42),61.9%(26/42),respectively,and the total survivals were 83.3%(35/42),73.8%(31/42),respectively. The 3-,5-year DFS of traditional treatment group were 50.0%(18/36),38.9%(14/36),respectively,the total survivals were 61.1%(22/36),50.0%(18/36),respectively.The 3-,5-year DFS and total survivals of endocrine therapy group were higher than those of traditional treatment group(all P<0.05).Conclusion Endocrine therapy can improve the survival rate,reduce the recurrence/metastasis rate and mortality of breast cancer patients with ER ,PR from negative to positive after neoad-juvant chemotherapy .