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目的研究蒽环类联合紫杉类方案对三阴型乳腺癌进行新辅助化疗的疗效,应用动态增强磁共振成像(MRI)及组织病理学进行疗效评价。方法选择2008年1月至2011年12月北京大学第一医院乳腺疾病中心初始实施蒽环类联合紫杉类新辅助化疗并完成手术的三阴型乳腺癌病人为研究对象。疗效评价包括动态增强MRI临床评价及组织病理学评价。定义MRI评价包括临床完全缓解、临床部分缓解为临床评价有效,计算临床有效率;定义病理分级G3~G5为病理评价有效,计算病理有效率。结果共诊治1190例新发乳腺癌,其中三阴型乳腺癌129例(占10.8%),41例符合入组标准,新辅助治疗临床评价有效率为65.85%(27/41),病理评价有效率为85.37%(35/41),其中病理完全缓解率(pCR)为36.59%(15/41),新辅助治疗MRI评价与病理评价符合率为77.1%。结论蒽环类联合紫衫类方案是治疗三阴型乳腺癌的有效方法。动态增强MRI能准确评价三阴型乳腺癌新辅助化疗疗效,并与病理评价相符合。
Objective To study the efficacy of anthracycline combined with taxane in the neoadjuvant chemotherapy for triple-negative breast cancer, and evaluate its efficacy by dynamic contrast-enhanced magnetic resonance imaging (MRI) and histopathology. Methods From January 2008 to December 2011, the First Affiliated Hospital of Peking University First Affiliated Hospital of Breast Disease Center, the initial implementation of anthracycline combined with taxane neoadjuvant chemotherapy and complete operation of the triple-negative breast cancer patients as the research object. Efficacy evaluation including dynamic enhanced MRI clinical evaluation and histopathological evaluation. The definition of MRI evaluation includes clinical complete remission, partial clinical remission for clinical evaluation of effective, effective clinical calculation; defined pathological grading G3 ~ G5 effective for pathological evaluation of pathological efficiency. Results A total of 1190 cases of new breast cancer were diagnosed and treated, among which 129 cases (10.8%) had triple negative breast cancer and 41 cases met the inclusion criteria. The effective rate of neoadjuvant therapy in clinical evaluation was 65.85% (27/41) The efficiency was 85.37% (35/41). The pathologic complete response rate (pCR) was 36.59% (15/41). The coincidence rate of neoadjuvant MRI and pathological evaluation was 77.1%. Conclusions anthracycline combined with purple shirt program is an effective method for the treatment of triple-negative breast cancer. Dynamic contrast-enhanced MRI can accurately evaluate the efficacy of neoadjuvant chemotherapy in triple-negative breast cancer and is consistent with pathological evaluation.