中华实验外科杂志
中華實驗外科雜誌
중화실험외과잡지
CHINESE JOURNAL OF EXPERIMENTAL SURGERY
2014年
12期
2832-2835
,共4页
乳腺肿瘤%新辅助化疗%预后
乳腺腫瘤%新輔助化療%預後
유선종류%신보조화료%예후
Breast neoplasms%Neoadjuvant chemotherapy%Prognosis
目的 探讨表阿霉素联合多西他赛的新辅助化疗(NAC)在不同分子分型乳腺癌中的疗效以及预后的影响.方法 收集采用NAC的83例晚期乳腺癌患者的临床资料,分析不同分子亚型和各生物学因子化疗前后的变化与NAC疗效的关系.结果 NAC后总有效率(RR)为81.9％(68/83),病理完全缓解(pCR)为7例(8.4％),临床完全缓解(cCR) 12例(14.5％),部分缓解(PR)49例(59.0％),病情稳定(SD)15例(18.1％),无疾病进展病例.不同分子亚型与NAC疗效相关,各分子亚型之间在pCR、cCR方面差异无统计学意义(P＞0.05).ERBB2+亚型组、Basal-like亚型组的CR和RR优于Luminal亚型组.雌激素受体(ER)、细胞核增殖抗原(Ki-67)化疗前后变化与疗效相关.Ki-67阳性组与阴性组在(pCR+ cCR)和(PR +SD)间差异有统计学意义(P＜0.05).各分子亚型在29个月无病生存率(DFS)和总生存率(OS)方面差异无统计学意义(P＞0.05).不同疗效患者间DFS差异有统计学意义,cCR患者优于PR患者.结论 乳腺癌分子分型可以作为NAC疗效的预测指标,ERBB2+亚型和Basal-like亚型获益更多,ER和Ki-67化疗前后变化与疗效相关,Ki-67高表达可作为预测NAC的敏感性指标,各分子亚型3年内的生存率无差异.NAC达到的不同疗效将会影响患者的无病生存率.
目的 探討錶阿黴素聯閤多西他賽的新輔助化療(NAC)在不同分子分型乳腺癌中的療效以及預後的影響.方法 收集採用NAC的83例晚期乳腺癌患者的臨床資料,分析不同分子亞型和各生物學因子化療前後的變化與NAC療效的關繫.結果 NAC後總有效率(RR)為81.9％(68/83),病理完全緩解(pCR)為7例(8.4％),臨床完全緩解(cCR) 12例(14.5％),部分緩解(PR)49例(59.0％),病情穩定(SD)15例(18.1％),無疾病進展病例.不同分子亞型與NAC療效相關,各分子亞型之間在pCR、cCR方麵差異無統計學意義(P＞0.05).ERBB2+亞型組、Basal-like亞型組的CR和RR優于Luminal亞型組.雌激素受體(ER)、細胞覈增殖抗原(Ki-67)化療前後變化與療效相關.Ki-67暘性組與陰性組在(pCR+ cCR)和(PR +SD)間差異有統計學意義(P＜0.05).各分子亞型在29箇月無病生存率(DFS)和總生存率(OS)方麵差異無統計學意義(P＞0.05).不同療效患者間DFS差異有統計學意義,cCR患者優于PR患者.結論 乳腺癌分子分型可以作為NAC療效的預測指標,ERBB2+亞型和Basal-like亞型穫益更多,ER和Ki-67化療前後變化與療效相關,Ki-67高錶達可作為預測NAC的敏感性指標,各分子亞型3年內的生存率無差異.NAC達到的不同療效將會影響患者的無病生存率.
목적 탐토표아매소연합다서타새적신보조화료(NAC)재불동분자분형유선암중적료효이급예후적영향.방법 수집채용NAC적83례만기유선암환자적림상자료,분석불동분자아형화각생물학인자화료전후적변화여NAC료효적관계.결과 NAC후총유효솔(RR)위81.9％(68/83),병리완전완해(pCR)위7례(8.4％),림상완전완해(cCR) 12례(14.5％),부분완해(PR)49례(59.0％),병정은정(SD)15례(18.1％),무질병진전병례.불동분자아형여NAC료효상관,각분자아형지간재pCR、cCR방면차이무통계학의의(P＞0.05).ERBB2+아형조、Basal-like아형조적CR화RR우우Luminal아형조.자격소수체(ER)、세포핵증식항원(Ki-67)화료전후변화여료효상관.Ki-67양성조여음성조재(pCR+ cCR)화(PR +SD)간차이유통계학의의(P＜0.05).각분자아형재29개월무병생존솔(DFS)화총생존솔(OS)방면차이무통계학의의(P＞0.05).불동료효환자간DFS차이유통계학의의,cCR환자우우PR환자.결론 유선암분자분형가이작위NAC료효적예측지표,ERBB2+아형화Basal-like아형획익경다,ER화Ki-67화료전후변화여료효상관,Ki-67고표체가작위예측NAC적민감성지표,각분자아형3년내적생존솔무차이.NAC체도적불동료효장회영향환자적무병생존솔.
Objective To discuss the relationship between molecular subtypes and therapeutic effect and prognosis of advanced breast cancer patients treated with neoadjuvant chemotherapy (NAC).Methods The data of 83 patients with advanced breast cancer undergoing NAC were collected.The relationship of molecular subtypes and changes in biological factors and therapeutic effect of NAC was analyzed.Results Response rate was 81.9％ (68/83),including 7 cases of pathologic complete response (8.4％),12 cases of clinical complete response (14.5％),and 49 cases of partial response (59.0％).There were 15 cases of stable disease (18.1％).Molecular subtypes were correlated with therapeutic effect of NAC.There was no significant difference in pathologic complete response and clinical complete response among different molecular subtypes.The complete response and response rate in ERBB2 + subtype and Basal-like subtype was higher than Luminal subtype.The changes in biological factors were statistically correlated with therapeutic effect of NAC.There was significant difference in pCR + cCR and PR + SD between proliferation cell nuclear antigen (Ki-67) + and Ki-67-.There was no significant difference in 29-month diseas-free survival (DFS) and overall survival among different molecular subtypes.There was significant difference in DFS among patients with different therapeutic effects and DFS in patients with cCR was higher than in those with PR.Conclusion Molecular subtypes of advanced breast cancer can predict therapeutic effect of NAC.The ERBB2 + subtype and Basal-like subtype can get more benefit from NAC.The changes in biological factors correlated therapeutic effect of NAC.The high expression of Ki-67 can be regarded as a sensitive predictor for NAC.There was no significant difference in 3-year survival among different molecular subtypes.The different therapeutic effects of NAC may have an effect on the DFS.
