中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2014年
17期
32-35
,共4页
范小庆%雷秋模%熊秋云%涂剑红%杜哲明
範小慶%雷鞦模%熊鞦雲%塗劍紅%杜哲明
범소경%뢰추모%웅추운%도검홍%두철명
分子生物学%炎性乳腺癌%新辅助化疗
分子生物學%炎性乳腺癌%新輔助化療
분자생물학%염성유선암%신보조화료
Molecular biology%Inflammatory breast cancer%Neoadjuvant chemotherapy
目的 探讨炎性乳腺癌(IBC)的分子生物学特点与新辅助化疗疗效的关系及影响化疗疗效的相关因素.方法 收集2005年1月至2013年6月收治的103例术前化疗的IBC患者临床资料,应用免疫组织化学方法检测乳腺癌组织的雌激素受体(ER)、孕激素受体(PR)、人表皮生长因子受体2(HER-2)及E钙黏蛋白(E-cadherin)的表达,评价IBC新辅助化疗的疗效.结果 103例IBC患者ER阴性48例,PR阴性51例,HER-2阳性45例,E-cadherin阳性66例.总体化疗有效率为72.8％ (75/103),联合紫杉类为主化疗方案的患者(紫杉组,62例)化疗有效率显著高于蒽环类为主化疗方案的患者(蒽环组,41例)[80.6％(50/62)比61.0％(25/41)],差异有统计学意义(P＜0.05);ER阴性、PR阴性、E-cadherin阴性的患者化疗有效率均显著高于其对应的ER阳性、PR阳性、E-cadherin阳性的患者[83.3％ (40/48)比63.6％ (35/55)、82.4％ (42/51)比63.5％ (33/52)、83.8％(31/37)比66.7％(44/66)],差异有统计学意义(P＜0.05);紫杉组E-cadherin阳性表达的患者化疗有效率显著高于蒽环组[77.5％(31/40)比50.0％(13/26)],差异有统计学意义(P＜ 0.05);HER-2的表达与炎性乳腺癌患者的化疗疗效无相关性(P＞0.05).结论 ER、PR及E-cadherin阴性的患者对IBC患者化疗敏感,E-cadherin的阳性表达可能是影响IBC患者化疗耐药的重要因素,选择含紫杉类药物联合化疗方案有助于提高E-cadherin阳性IBC患者的化疗疗效.
目的 探討炎性乳腺癌(IBC)的分子生物學特點與新輔助化療療效的關繫及影響化療療效的相關因素.方法 收集2005年1月至2013年6月收治的103例術前化療的IBC患者臨床資料,應用免疫組織化學方法檢測乳腺癌組織的雌激素受體(ER)、孕激素受體(PR)、人錶皮生長因子受體2(HER-2)及E鈣黏蛋白(E-cadherin)的錶達,評價IBC新輔助化療的療效.結果 103例IBC患者ER陰性48例,PR陰性51例,HER-2暘性45例,E-cadherin暘性66例.總體化療有效率為72.8％ (75/103),聯閤紫杉類為主化療方案的患者(紫杉組,62例)化療有效率顯著高于蒽環類為主化療方案的患者(蒽環組,41例)[80.6％(50/62)比61.0％(25/41)],差異有統計學意義(P＜0.05);ER陰性、PR陰性、E-cadherin陰性的患者化療有效率均顯著高于其對應的ER暘性、PR暘性、E-cadherin暘性的患者[83.3％ (40/48)比63.6％ (35/55)、82.4％ (42/51)比63.5％ (33/52)、83.8％(31/37)比66.7％(44/66)],差異有統計學意義(P＜0.05);紫杉組E-cadherin暘性錶達的患者化療有效率顯著高于蒽環組[77.5％(31/40)比50.0％(13/26)],差異有統計學意義(P＜ 0.05);HER-2的錶達與炎性乳腺癌患者的化療療效無相關性(P＞0.05).結論 ER、PR及E-cadherin陰性的患者對IBC患者化療敏感,E-cadherin的暘性錶達可能是影響IBC患者化療耐藥的重要因素,選擇含紫杉類藥物聯閤化療方案有助于提高E-cadherin暘性IBC患者的化療療效.
목적 탐토염성유선암(IBC)적분자생물학특점여신보조화료료효적관계급영향화료료효적상관인소.방법 수집2005년1월지2013년6월수치적103례술전화료적IBC환자림상자료,응용면역조직화학방법검측유선암조직적자격소수체(ER)、잉격소수체(PR)、인표피생장인자수체2(HER-2)급E개점단백(E-cadherin)적표체,평개IBC신보조화료적료효.결과 103례IBC환자ER음성48례,PR음성51례,HER-2양성45례,E-cadherin양성66례.총체화료유효솔위72.8％ (75/103),연합자삼류위주화료방안적환자(자삼조,62례)화료유효솔현저고우은배류위주화료방안적환자(은배조,41례)[80.6％(50/62)비61.0％(25/41)],차이유통계학의의(P＜0.05);ER음성、PR음성、E-cadherin음성적환자화료유효솔균현저고우기대응적ER양성、PR양성、E-cadherin양성적환자[83.3％ (40/48)비63.6％ (35/55)、82.4％ (42/51)비63.5％ (33/52)、83.8％(31/37)비66.7％(44/66)],차이유통계학의의(P＜0.05);자삼조E-cadherin양성표체적환자화료유효솔현저고우은배조[77.5％(31/40)비50.0％(13/26)],차이유통계학의의(P＜ 0.05);HER-2적표체여염성유선암환자적화료료효무상관성(P＞0.05).결론 ER、PR급E-cadherin음성적환자대IBC환자화료민감,E-cadherin적양성표체가능시영향IBC환자화료내약적중요인소,선택함자삼류약물연합화료방안유조우제고E-cadherin양성IBC환자적화료료효.
Objective To explore the relationship of molecular biology characteristic and the treatment outcome,and influence factors of neoadjuvant chemotherapy (NAC) in inflammatory breast cancer (IBC).Methods The clinicopathological data of 103 IBC patients who were treated with NAC from January 2005 to June 2013 were analyzed retrospectively.Immunohistochemical method was used to detect the expression of estrogen receptor (ER),progesteron receptor (PR),human epidermal growth factor receptor 2 (HER-2) and E-cadherin.The treatment outcome were evaluated.Results In 103 IBC patients,ER negative was 48 patients,PR negative was 51 patients,HER-2 positive was 45 patients,E-cadherin positive was 66 patients.The effective rate of chemotherapy was 72.8％ (75/103).The effective rate of chemotherapy in taxane-based group was significantly higher than that in anthracycline-based group [80.6％ (50/62) vs.61.0％(25/41)],and there was significant difference (P ＜ 0.05).The effective rate of chemotherapy in ER,PR,E-cadherin negative patients was significantly higher than that in ER,PR,E-cadherin positive patients [83.3％ (40/48) vs.63.6％ (35/55),82.4％ (42/51) vs.63.5％ (33/52),83.8％ (31/37) vs.66.7％ (44/66)],and there was significant difference (P ＜ 0.05).The effective rate of chemotherapy in taxane-based group with E-cadherin positive patients was significantly higher than that in anthracycline-based group with E-cadherin positive patients [77.5％ (31/40) vs.50.0％ (13/26)] (P ＜0.05).No correlation existed between the expression of HER-2 and the treatment outcome of chemotherapy (P ＞ 0.05).Conclusion ER,PR and E-cadherin negative patients with IBC is chemosensitive to NAC.The positive expression of E-cadherin may be an important factor of chemotherapy resistance.For the patients with E-cadherin positive,taxane-based chemotherapy regimen can achieve a better effective rate.
