贵州医科大学学报

2015, v.40;No.173(02) 159-162+165

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不同分子亚型乳腺癌新辅助化疗疗效观察
Curative Effect of Neoadjuvant Chemotherapy on Different Molecular Subtypes of Breast Cancer

刘英;黄建军;
LIU Ying;HUANG Jianjun;Department of General Surgery,Dazhou Second People's Hospital;Department of Breast Surgery,the Affiliated Hospital of Guiyang Medical College;

摘要(Abstract):

目的:观察表柔比星联合环磷酰胺的新辅助化疗方案(EC方案)对不同分子亚型乳腺癌的疗效。方法:对接受EC化疗方案的89例乳腺癌病人应用免疫组织化学方法检测雌激素受体(ER)、孕激素受体(PR)、人表皮生长因子受体2(HER-2)、表皮生长因子受体(EGFR)以及细胞角蛋白5/6(CK5/6)表达,依据5个因子的表达水平将患者分为Luminal A型、Luminal B型、HER-2(+)型、基底细胞(basal-like)型及正常乳腺样(normal breast-like)型5个分子亚型,分析不同分子亚型新辅助化疗疗效。结果:89例患者Luminal A型者占42.7%(38/89)、Luminal B型占28.1%(25/89)、HER-2(+)型占14.6%(13/89)、basal-like型占4.5%(4/89)及normal breast-like型占10.1%(9/89);89例乳腺癌患者经4个周期EC方案新辅助化疗后,7.9%(7/89)达病理完全缓解(p CR),9%(8/89)达完全缓解(CR),75.3%(67/89)达部分缓解(PR),客观有效(CR+PR)率84.3%,7.9%(7/89)的病人病情稳定(SD),无疾病进展(PD)病例;basal-like型乳腺癌p CR率高,为75%(3/4),占总的病理完全缓解人数的42.9%(3/7),各亚组间发病年龄、AJCC分期、肿瘤大小、淋巴结状态、临床有效差异无统计学意义,是否p CR各亚组间差异有统计学意义(P<0.05)。结论:乳腺癌分子分型可作为乳腺癌p CR的预测因子,相比之下,basal-like亚型乳腺癌可能具有更高的p CR。
Objective: To investigate the curative effect of neoadjuvant chemotherapy under the scheme of epirubicin combined cyclophosphamide( EC) on different molecular subtypes of breast cancer. Methods: Analyzing 89 patients who accepted preoperative chemotherapy under the scheme of EC,testing the immunohistochemical expression levels of ER,PR,HER-2,EGFR and CK5 /6,then,the patients were divided into the type of Luminal A,the type of Luminal B,the type of HER-2( +),the type of basal-like and the type of normal breast-like,the curative effect of neoadjuvant chemotherapy in different molecular subtypes was analyzed. Results: The type of Luminal A,the type of Luminal B,the type of HER-2( +),the type of basal-like and the type of normal breast-like was respectively accounted for proportion of 42. 7%( 38 /89),28. 1%( 25 /89),14. 6%( 13 /89),4. 5%( 4 /89),10. 1%( 9 /89) in 89 cases. These patients accepted four cycles of EC plan chemotherapy,7. 9%( 7 /89) reached pathologic complete remission( p CR),9%( 8 /89) attained complete response( CR),75. 3%( 67 /89) had partial remission( PR),84. 3% had the objective effective rate( CR + PR),7. 9%( 7 /89) had stable disease condition( SD),none had progression of disease( PD). The type of basal-like had a high rate of p CR,75%( 3 /4),accounted for 42. 9%( 3 /7) in all p CR. There were no statistical differences in onset age,AJCC stage,tumor size,lymph node status,clinical effective,while there was statistical significance in whether the pathological complete response among different subgroups. Conclusions: Breast cancer molecular classification can serve as a predictor of breast cancer,by contrast,the type of basal-like breast cancer has a higher rate of p CR.

关键词(KeyWords): 乳腺肿瘤;癌;分型;新辅助化疗;疗效
breast neoplasms;carcinoma;type;neoadjuvant chemotherapy;curative effects

Abstract:

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基金项目(Foundation): 贵州省科技厅基金[黔科合LG字(2011)041号]

作者(Author): 刘英;黄建军;
LIU Ying;HUANG Jianjun;Department of General Surgery,Dazhou Second People's Hospital;Department of Breast Surgery,the Affiliated Hospital of Guiyang Medical College;

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