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[目的]探索IGF-ⅠR对乳腺癌新辅助化疗(NAC)疗效的预测价值。[方法]纳入40例接受NAC的原发性乳腺癌患者,测定NAC前肿瘤组织中IGF-ⅠR的表达情况,分析其与NAC疗效之间的关系。[结果]IGF-ⅠR阳性率为42.5%(17/40)。IGF-ⅠR阴性患者在接受NAC后的PR率为82.6%,高于IGF-ⅠR阳性患者(47.1%,P=0.018)。对化疗方案进行分层分析,在蒽环类药物组中,IGF-ⅠR阴性患者的PR率显著高于IGF-ⅠR阳性患者(83.3%vs33.3%,P=0.013),而在蒽环联合紫杉类药物组中,IGF-ⅠR表达情况与PR率无关(81.8%vs80.0%,P=0.931)。[结论]测定IGF-ⅠR可以预测乳腺癌NAC的疗效,指导NAC方案的选择。对IGF-ⅠR阴性的患者,预计NAC的有效率较高,建议实施NAC,首选蒽环类方案,而对IGF-ⅠR阳性的患者,预计NAC的有效率较低,不建议首选NAC,如确需选择NAC,则建议采用蒽环联合紫杉类药物的方案。
[Objective] To explore the predictive value of IGF-ⅠR in the efficacy of neoadjuvant chemotherapy (NAC) for breast cancer. [Methods] Forty patients with primary breast cancer receiving NAC were enrolled in this study. The expression of IGF-ⅠR in pre-NAC tumor tissue was determined and the relationship between the therapeutic effect and NAC was analyzed. [Results] The positive rate of IGF-ⅠR was 42.5% (17/40). The PR rate in patients with IGF-IR negative after receiving NAC was 82.6%, higher than those with IGF-IR (47.1%, P = 0.018). The stratified analysis of chemotherapy regimens showed that in the anthracycline group, the PR rate was significantly higher in patients with IGF-IR than in patients with IGF-IR (83.3% vs33.3%, P = 0.013) In the taxane group, the expression of IGF-ⅠR was not related to PR (81.8% vs80.0%, P = 0.931). [Conclusion] The determination of IGF-ⅠR can predict the efficacy of NAC in breast cancer and guide the choice of NAC regimen. NAC is expected to be more effective in IGF-IR-negative patients and NAC is recommended as the preferred anthracycline regimen whereas NAC is expected to be less effective in IGF-IR-positive patients and NAC is not recommended Need to choose NAC, it is recommended anthracycline combined with taxane drugs program.