中国实用医刊
中國實用醫刊
중국실용의간
CENTRAL PLAINS MEDICAL JOURNAL
2008年
16期
7-9
,共3页
乳腺癌%新辅助化疗%病理组织学%免疫组化
乳腺癌%新輔助化療%病理組織學%免疫組化
유선암%신보조화료%병리조직학%면역조화
Breast carcinoma%Neoadjuvant chemotherapy%Histopathology%Immunohistochemistry
目的 观察乳腺癌新辅助化疗后的临床病理学改变及意义.方法 60例局部进展期乳腺癌均经空心针穿刺获取组织学证实为乳腺癌,并作免疫组化行ER、PR、cerb-B2、P53、Topo-Ⅱ检测,新辅助化疗采用FEC常规化疗方案,完成4周期新辅助化疗后进行临床疗效评价.对术后标本进行常规HE、免疫组织化学染色观察.结果 总有效率(RR)为91.66%(55/60),临床完全缓解率(eCR)为28.33%(17/60),临床部分缓解率(cPR)为63.33%(38/60),无变化(NC)8.33%(5/60),无疾病进展患者.其中病理完全缓解率(pCR)为23.33%(14/60),行保乳手术16例,保乳率为26.67%(16/60).与术前病理活检标本比较,新辅助化疗后瘤体缩小变软、甚至消失,肿瘤细胞退变坏死,化疗后乳腺癌标本间质水肿、间质增生胶原化明显,癌旁乳腺组织部分导管上皮可呈轻-中度异型性;淋巴结无论有无转移均可见结构改变,转移淋巴结内可见肿瘤细胞退变坏死、间质炎细胞浸润及纤维化等.免疫组织化学未见ER、PR表达变化,cerb-B2、P53、Topo-Ⅱ表达差异无统计学意义.结论 FEC新辅助化疗使多数乳腺癌原发灶及淋巴结转移灶出现不同程度变性坏死,提高手术率并增加了保乳机会,在术后辅助治疗及判断预后方面具有重要临床意义.
目的 觀察乳腺癌新輔助化療後的臨床病理學改變及意義.方法 60例跼部進展期乳腺癌均經空心針穿刺穫取組織學證實為乳腺癌,併作免疫組化行ER、PR、cerb-B2、P53、Topo-Ⅱ檢測,新輔助化療採用FEC常規化療方案,完成4週期新輔助化療後進行臨床療效評價.對術後標本進行常規HE、免疫組織化學染色觀察.結果 總有效率(RR)為91.66%(55/60),臨床完全緩解率(eCR)為28.33%(17/60),臨床部分緩解率(cPR)為63.33%(38/60),無變化(NC)8.33%(5/60),無疾病進展患者.其中病理完全緩解率(pCR)為23.33%(14/60),行保乳手術16例,保乳率為26.67%(16/60).與術前病理活檢標本比較,新輔助化療後瘤體縮小變軟、甚至消失,腫瘤細胞退變壞死,化療後乳腺癌標本間質水腫、間質增生膠原化明顯,癌徬乳腺組織部分導管上皮可呈輕-中度異型性;淋巴結無論有無轉移均可見結構改變,轉移淋巴結內可見腫瘤細胞退變壞死、間質炎細胞浸潤及纖維化等.免疫組織化學未見ER、PR錶達變化,cerb-B2、P53、Topo-Ⅱ錶達差異無統計學意義.結論 FEC新輔助化療使多數乳腺癌原髮竈及淋巴結轉移竈齣現不同程度變性壞死,提高手術率併增加瞭保乳機會,在術後輔助治療及判斷預後方麵具有重要臨床意義.
목적 관찰유선암신보조화료후적림상병이학개변급의의.방법 60례국부진전기유선암균경공심침천자획취조직학증실위유선암,병작면역조화행ER、PR、cerb-B2、P53、Topo-Ⅱ검측,신보조화료채용FEC상규화료방안,완성4주기신보조화료후진행림상료효평개.대술후표본진행상규HE、면역조직화학염색관찰.결과 총유효솔(RR)위91.66%(55/60),림상완전완해솔(eCR)위28.33%(17/60),림상부분완해솔(cPR)위63.33%(38/60),무변화(NC)8.33%(5/60),무질병진전환자.기중병리완전완해솔(pCR)위23.33%(14/60),행보유수술16례,보유솔위26.67%(16/60).여술전병리활검표본비교,신보조화료후류체축소변연、심지소실,종류세포퇴변배사,화료후유선암표본간질수종、간질증생효원화명현,암방유선조직부분도관상피가정경-중도이형성;림파결무론유무전이균가견결구개변,전이림파결내가견종류세포퇴변배사、간질염세포침윤급섬유화등.면역조직화학미견ER、PR표체변화,cerb-B2、P53、Topo-Ⅱ표체차이무통계학의의.결론 FEC신보조화료사다수유선암원발조급림파결전이조출현불동정도변성배사,제고수술솔병증가료보유궤회,재술후보조치료급판단예후방면구유중요림상의의.
Objective To investigate histopathological changes of breast carcinoma following neoadjuvant chemotherapy.Methods Samples were obtained from 60 patients with breast carcinoma who received neoadjuvant chemotherapy of 5 - fluorou-raeil,epirubicin and cyclophosphamide, histopathologic examination and immunohistoehemical examination including ER, PR,cerb - B2, P53 and Topo - Ⅱ were carried out both pre -chemotherapy core biopsies and post - chemotherapy surgical speci-mens. Results The total response rate RR was 91.66% (55/60). A total of 28.33% (17/60) of the patients acquired clinical complete response ,63.33% (38/60) clinical partial response, and 8.33% (5/60)no change. Fourteen cases obtained pathologic complete response and no progressive disease in all patients. Histopathologic changes, such as disintegration, necrosis, infiltra-tion of inflammatory cell, stromal edema and fibrosis occurred after neoadjuvant chemotherapy. The same changes were observed in the metastatic lymph nodes. Atypical Hyperplasia was also observed in the vicinity of tumor tissue after neoadjuvant chemothera-py. The expression of ER, PB, and cerb - B2, P53, Topo -Ⅱ didn't change significantly. Conclusion Neoadjuvant chemothera-py with FEC regimens is effective to both primary tumors and metastatic lymph nodes in breast cancer.
