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目的探讨乳腺癌分子分型对多西他塞联合表柔比星新辅助化疗(TE-NAC)疗效的预测价值。方法选取2013年1月至2014年12月间青岛市中心医院收治的128例乳腺癌患者,于化疗前后进行免疫组化分析,按照分子分型结果分为A组(Luminal A型)、B组(Luminal B型)、C组(Her-2型)和D组(Basal-like型)四组。比较四组患者临床疗效,并对四组疗效行多因素Cox回归分析。结果四组患者年龄、病灶直径、肿瘤分期临床分期和区域淋巴结等差异无统计学意义(P>0.05)。A组、B组、C组和D组病理完全缓解率(pCR)分别为12.1%、10.8%、37.5%和75.0%,有效(RR)率分别为45.5%、59.0%、87.5%和100.0%,差异均有统计学意义(均P<0.05)。A组、B组、C组和D组患者无瘤生存率分别为75.8%、69.9%、37.5%和25.0%,患者3年总生存率分别为81.8%、80.7%、50.0%和25.0%,四组患者无瘤生存率和总生存率比较,差异有统计学意义(P<0.05)。多因素Cox回归分析,乳腺癌分子亚型为NAC疗效的独立影响因素。结论乳腺癌分子分型可以作为TE-NAC疗效的预测指标。
Objective To investigate the predictive value of molecular typing of breast cancer on the efficacy of docetaxel combined with epirubicin neoadjuvant chemotherapy (TE-NAC). Methods A total of 128 breast cancer patients from January 2013 to December 2014 in Qingdao Central Hospital were enrolled in this study. Immunohistochemical analysis was performed before and after chemotherapy. According to the molecular typing results, the patients were divided into three groups: Luminal A type, (Luminal B type), C group (Her-2 type) and D group (Basal-like type) four groups. The clinical efficacy of the four groups were compared, and the multivariate Cox regression analysis was used to evaluate the efficacy of the four groups. Results There were no significant differences in age, lesion diameter, clinical staging and regional lymph node metastasis between the four groups (P> 0.05). The complete remission rate (pCR) of group A, group B, group C and group D were 12.1%, 10.8%, 37.5% and 75.0% respectively, and the effective rates were 45.5%, 59.0%, 87.5% and 100.0% , The differences were statistically significant (all P <0.05). The tumor-free survival rates of patients in groups A, B, C and D were 75.8%, 69.9%, 37.5% and 25.0%, respectively. The 3-year overall survival rates were 81.8%, 80.7%, 50.0% and 25.0% There was a significant difference between the two groups in tumor-free survival and overall survival (P <0.05). Multivariate Cox regression analysis showed that breast cancer subtypes were independent influencing factors of NAC efficacy. Conclusion Breast cancer molecular typing can be used as a predictor of TE-NAC efficacy.