包刚
BAO Gang

• 1:贵州医科大学附院乳腺外科

摘要(Abstract)：

目的:探讨新辅助化疗前后乳腺癌组织中雌激素受体(ER)、孕激素受体(PR)的变化及临床价值。方法:行新辅助化疗的乳腺癌患者123例,术前穿刺取病变部位组织活检和手术时取癌组织标本,采用免疫组化Powervision两步法检测ER、PR的蛋白表达,观察化疗后临床病理特征与新辅助化疗疗效,分析新辅助化疗前后ER和PR蛋白表达变化与临床病理特征的关系。结果:新辅助化疗临床有效率为85.4%,其中CR为28.5%、PR为56.9%及SD为14.6%,术后证实病理完全缓解5例(4.1%);年龄、淋巴结状态、临床分期与新辅助化疗疗效无明显关系(P>0.05),而肿瘤大小、ER及PR状态与新辅助化疗疗效具有一定关系(P<0.05),肿瘤越大,ER及PR阴性患者,新辅助化疗效果较好;ER新辅助化疗前阳性表达率低于化疗后(P<0.05),PR新辅助化疗前阳性表达率与化疗后差异无统计学意义(P>0.05);ER和PR阳性表达在年龄<50岁组、肿瘤大小、淋巴结状态及分期组间比较,差异无统计学意义(P>0.05),仅ER表达在年龄≥50岁组,差异有统计学意义(P<0.05)。结论:乳腺癌ER和PR状态与新辅助化疗疗效可能有关,新辅助化疗可使部分乳腺癌组织中的ER表达发生改变,但对PR表达无影响。
Objective: To investigate the changes of the expression of estrogen receptor( ER) and progesterone receptor( PR) in breast cancer before and after neoadjuvant chemotherapy. Methods: A total of 123 breast cancer patients were accepted neoadjuvant chemotherapy. Adopting immunohistochemistry Powervision method to detect protein expressions of ER,PR in cancer tissues before and after operation. The clinical pathological features and curative effects of neoadjuvant chemotherapy were observed,and the relationships between hormone receptors and clinical pathological features were analyzed. Results: The total clinical effective rate( RR) was 85. 4%,of which the clinical complete remission( CR),partial clinical response( PR) and the stable disease( SD) were 28. 5%,56. 9% and14. 6%,respectively. Five patients( 4. 1%) achieved complete pathologic remission. There was no significant correlation of age,lymph node status and clinical stages with curative effects of neoadjuvant chemotherapy( P > 0. 05),while the curative effect was correlated with tumor size,ER and PR status( P < 0. 05). Patients with bigger tumor size,negative ER and PR expression had better curative effect.The ER positive rate before chemotherapy was lower than that after chemotherapy( P < 0. 05). In contrast,the PR positive rate before and after the chemotherapy showed no significant difference( P > 0.05). Differences in ER and PR positive expression rates among patients below 50 years old,patients with different tumor size,lymph node status and clinical stages were not significant( P > 0. 05); there were significant differences in ER expression among patients above 50 years old( P < 0. 05). Conclusion: The ER and PR status of breast cancer and neoadjuvant chemotherapy may have correlation. The neoadjuvant chemotherapy had effects on ER expression,but no effect on PR expression.

关键词(KeyWords)： 乳腺肿瘤;新辅助化疗;雌激素受体;孕激素受体
breast neoplasms;neoadjuvant chemotherapy;estrogen receptor;progesterone receptor

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 包刚
BAO Gang

DOI: 10.19367/j.cnki.1000-2707.2015.07.022

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