论文部分内容阅读
目的探讨乳腺癌新辅助化疗(neoadjuvant chemotherapy therapy,NACT)临床疗效与临床病理特点的相关性。方法收集2005年1月至2012年10月329例接受包含蒽环类和紫杉类药物方案NACT的乳腺癌患者临床资料,采用免疫组化法检测肿瘤穿刺组织的雌激素受体(ER)、孕激素受体(PR)、Her-2及Ki-67指数,分析乳腺癌分子分型和生物学标志物对NACT疗效的预测作用。结果在329例患者中,NACT总有效率82.37%(271/329),疾病稳定(SD)17.33%(57/329),疾病进展(PD)1例;病理完全缓解(pCR)81例(24.62%);pCR率:ER阴性>ER阳性、PR阴性>PR阳性、Her-2阳性>Her-2阴性患者、非乳腺腔内A型>乳腺腔内A型乳腺癌患者,临床有效率(CR+PR):Her-2阳性>阴性、高Ki-67指数(>30%的患者)>低Ki-67指数(<15%的患者)、非乳腺腔内A型>乳腺腔内A型乳腺癌患者。Her-2阳性是预测pCR的独立变量(P=0.006,OR=3.382;95%CI:1.408~8.126)。结论 ER阴性、PR阴性、Her-2阳性乳腺癌NACT后pCR率高;Her-2阳性、高Ki-67指数、非乳腺腔内A型NACT临床有效率高;Her-2阳性是乳腺癌NACT后pCR的独立预测因素。
Objective To investigate the clinical efficacy and clinical pathological characteristics of neoadjuvant chemotherapy therapy (NACT) in breast cancer. Methods The clinical data of 329 breast cancer patients receiving anthracycline and taxane containing NACT from January 2005 to October 2012 were collected. The estrogen receptor (ER), tumor necrosis factor Progesterone receptor (PR), Her-2 and Ki-67 index, and to predict the effect of breast cancer molecular typing and biomarkers on the efficacy of NACT. Results Among the 329 patients, the total effective rate of NACT was 82.37% (271/329), stable disease (SD) 17.33% (57/329), disease progression (PD), and pathologic complete response (pCR) %); pCR rate: ER negative> ER positive, PR negative PR positive, Her-2 positive> Her-2 negative patients, non breast type A> breast type A breast cancer patients, clinical effective rate + PR): Her-2 positive> negative, high Ki-67 index (> 30% of patients)> low Ki-67 index Cancer patients. Her-2 positivity was an independent predictor of pCR (P = 0.006, OR = 3.382; 95% CI: 1.408-8.126). Conclusions ER-negative, PR-negative, Her-2 positive breast cancer NACT after high pCR rate; Her-2 positive, high Ki-67 index, non-breast cavity A type NACT clinical effective; Her-2 positive breast cancer NACT Post-pCR independent predictors.