CAJ | 학술논문

目的前瞻性研究分子分型及动态增强MRI对乳腺癌新辅助治疗疗效的预测和评价价值.方法选择2010年1月至2011年12月实施新辅助治疗并完成R0切除手术的79例乳腺癌患者,均为女性,年龄28 ～67岁,中位年龄48岁；其中Luminal A型6例,Luminal B型42例,HER-2阳性型14例,三阴型17例.研究入组患者动态增强MRI评价与病理疗效评价间的关系,分析分子分型及动态增强MRI对新辅助治疗疗效的预测和评价作用.结果新辅助治疗临床有效率为83.5％(66/79),病理有效率为79.7％(63/79).79例患者中27例获得病理完全缓解(34.2％),其中Luminal B型12例(28.6％,12/42),HER-2阳性型5例(5/14),三阴型10例(10/17).分子分型与病理完全缓解具有统计学相关性(P =0.039).动态增强MRI临床疗效评价与病理疗效评价间有统计学相关性(r =0.432,P=0.000).结论分子分型对乳腺癌新辅助治疗疗效具有预测价值,动态增强MRI检查与新辅助治疗后组织病理疗效评价具有相关性,有助于新辅助治疗疗效评价.
목적 전첨성연구분자분형급동태증강MRI대유선암신보조치료료효적예측화평개개치.방법 선택2010년1월지2011년12월실시신보조치료병완성R0절제수술적79례유선암환자,균위녀성,년령28 ～67세,중위년령48세；기중Luminal A형6례,Luminal B형42례,HER-2양성형14례,삼음형17례.연구입조환자동태증강MRI평개여병리료효평개간적관계,분석분자분형급동태증강MRI대신보조치료료효적예측화평개작용.결과 신보조치료림상유효솔위83.5％(66/79),병리유효솔위79.7％(63/79).79례환자중27례획득병리완전완해(34.2％),기중Luminal B형12례(28.6％,12/42),HER-2양성형5례(5/14),삼음형10례(10/17).분자분형여병리완전완해구유통계학상관성(P =0.039).동태증강MRI림상료효평개여병리료효평개간유통계학상관성(r =0.432,P=0.000).결론 분자분형대유선암신보조치료료효구유예측개치,동태증강MRI검사여신보조치료후조직병리료효평개구유상관성,유조우신보조치료료효평개.
Objective To investigate the predictive value of molecular subtypes and the evaluational value of dynamic contrast-enhanced MRI of neoadjuvant chemotherapy for breast cancer.Methods From January 2010 to December 2011,the 79 patients diagnosed as primary invasive breast cancer,having received 6 cycles of neoadjuvant chemotherapy and finished the mastectomy or the breast conserving surgery entered this study.A total of 79 patients participated in this prospective study.There were 6 (7.6％) luminal A cases,42 (53.2％) luminal B cases,14 HER-2 (17.7％) positive cases and 17 (21.5％) triple negative cases.The associations between molecular subtypes and clinical response as well as the pathological response were analyzed.The predictive value of molecular subtypes for the neoadjuvant chemotherapy was studied.Results Clinical effective rate was 85.3％ (66/79).There was no statistical correlation between molecular subtypes and clinical effective rate.Pathologic effective rate was 79.7％ (63/79).There was no statistical correlation between molecular subtypes and pathologic effective rate.Twenty-seven case achieved pathologic complete remission (pCR) in all the patients.No case achieved pCR in the patients classified as Luminal A.Twelve cases (28.6％,12/42) achieved pCR in the luminal B patients.Five cases (5/14) achieved pCR in the HER-2 overexpression patients.Ten cases (10/17) achieved pCR in the triple-negative patients.There was a statistical correlation between the molecular subtypes and the pCR rate (P = 0.039),and between clinical evaluation by dynamic contrast-enhanced MRI and evaluation of pathological response (r =0.432,P = 0.000).Conclusions Molecular subtypes and dynamic contrast-enhanced MRI have a good value of predicting and evaluating the response of neoadjuvant chemotherapy on breast cancer.