CAJ | 학술논문

目的：探讨相关因素在新疆地区维吾尔族女性乳腺癌新辅助化疗(NAC)疗效中的意义。方法收集新疆医科大学第二附属医院及肿瘤医院2010年1月至2014年6月87例行NAC的维吾尔族女性乳腺癌患者的全部病历资料。NAC前均行肿块空心针穿刺活检病理确诊，并用免疫组化(IHC)方法明确患者雌激素受体(ER)、孕激素受体(PR)、人表皮生长因子受体2(Her-2)状态和肿瘤增殖指数(Ki-67)。分析患者年龄、绝经状态、体质指数(BMI)、肿块大小、腋窝淋巴结状况、临床分期、NAC周期数、分子分型对NAC有效率(CR+PR)和病理完全缓解(pCR)的预测作用。结果在87例患者中NAC总有效率为85.06%(74/87)，疾病稳定(SD)率为11.49%(10/87)，疾病进展(PD)率为3.45%(3/87)；pCR率为14.94%(13/87)。激素受体阴性、Ki-67指数>20%、体重指数(BMI)<25 kg/m2、非LuminaA型患者NAC疗效更好。NAC周期数>4个周期为预测pCR的独立变量(P=0.004，OR=0.081；95%CI：0.015~0.441)。结论 ER阴性、PR阴性、NAC周期>4个周期者pCR率更高。ER阴性、PR阴性、Ki-67指数>20%、非LuminaA型、BMI<25 kg/m2者NAC后临床有效率更高。NAC周期＞4周期为预测pCR的独立因素。
목적：탐토상관인소재신강지구유오이족녀성유선암신보조화료(NAC)료효중적의의。방법수집신강의과대학제이부속의원급종류의원2010년1월지2014년6월87례행NAC적유오이족녀성유선암환자적전부병력자료。NAC전균행종괴공심침천자활검병리학진，병용면역조화(IHC)방법명학환자자격소수체(ER)、잉격소수체(PR)、인표피생장인자수체2(Her-2)상태화종류증식지수(Ki-67)。분석환자년령、절경상태、체질지수(BMI)、종괴대소、액와림파결상황、림상분기、NAC주기수、분자분형대NAC유효솔(CR+PR)화병리완전완해(pCR)적예측작용。결과재87례환자중NAC총유효솔위85.06%(74/87)，질병은정(SD)솔위11.49%(10/87)，질병진전(PD)솔위3.45%(3/87)；pCR솔위14.94%(13/87)。격소수체음성、Ki-67지수>20%、체중지수(BMI)<25 kg/m2、비LuminaA형환자NAC료효경호。NAC주기수>4개주기위예측pCR적독립변량(P=0.004，OR=0.081；95%CI：0.015~0.441)。결론 ER음성、PR음성、NAC주기>4개주기자pCR솔경고。ER음성、PR음성、Ki-67지수>20%、비LuminaA형、BMI<25 kg/m2자NAC후림상유효솔경고。NAC주기＞4주기위예측pCR적독립인소。
Objective To assess the influencing factors of response to neoadiuvant chemotherapy (NAC) in Xinjiang Uighur females with breast cancer. Methods The clinical data of 87 Xinjiang Uighur females with breast cancer undergoing NAC from January 2010 to June 2014 were retrospectively studied. Estrogen receptor (ER), proges-terone receptor (PR), human epidermal growth factor receptor 2 (Her-2), proliferation index of Ki-67 were investigat-ed by immunohistochemistry. The role of age, menopausal status, body mass index (BMI), tumor size, axillary lymph node status, clinical stage, number of NAC cycles, molecular subtype for evaluating pathological complete response (pCR) rate and clinical effective rate [complete response (CR)+partial response (PR)] were analyzed. Results After NAC, the total clinical effctive rate (CR+PR) was 85.06%(74/87), with stable disease (SD) rate of 11.49%(10/87), progressive disease (PD) rate of 3.45%(3/87), pCR rate of 14.94%(13/87). The clinical effective rate (CR+PR) was associated with the expression of hormone receptor (ER and PR), Ki-67 index and molecular subtype:the clinical effi-cacay was better with HR negative, high Ki-67 index (>20%), BMI<25 kg/m2, non-luminal A than HR positive, low Ki-67 index (<20%), BMI≥25 kg/m2, luminal A. NAC cycles>4 cycles was an independent factor for predicting pCR after NAC (P=0.004, OR=0.081;95%CI:0.015~0. 441). Conclusion Patients with hormone receptor negative (ER, PR), high Ki-67 index (>20%), non-luminal A, BMI<25 kg/m2 have a higher clinical effective rate (CR+PR). The pCR rate is higher with hormone receptor nagative, NAC cycles>4 cycles, and NAC cycles>4 cycles is an independent factor for predicting pCR after NAC.