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中华乳腺病杂志(电子版) ›› 2011, Vol. 05 ›› Issue (03) : 283 -289. doi: 10.3877/cma.j.issn.1674-0807.2011.03.003

临床研究

术前新辅助短程密集化疗疗效与乳腺癌受体亚型及组织学类型的关系
周艳1, 明佳1, 唐鹏1, 范林军1, 张毅1, 杨新华1, 姜军1   
  1. 1.400038 重庆,第三军医大学附属西南医院乳腺疾病中心
  • 收稿日期:2010-11-10 出版日期:2011-06-01

Relevance between histological and receptor-based subtypes and the response rate after short intensive neoadjuvant chemotherapy in breast cancer patients

Yan ZHOU1, Jia MING1, Peng TANG1, Lin-jun FAN1, Yi ZHANG1, Xin-hua YANG1, Jun JIANG1   

  1. 1.Breast Diseases Center, Southwest Hospital, Third Military Medical University, Chongqing 400038, China
  • Received:2010-11-10 Published:2011-06-01
引用本文:

周艳, 明佳, 唐鹏, 范林军, 张毅, 杨新华, 姜军. 术前新辅助短程密集化疗疗效与乳腺癌受体亚型及组织学类型的关系[J/OL]. 中华乳腺病杂志(电子版), 2011, 05(03): 283-289.

Yan ZHOU, Jia MING, Peng TANG, Lin-jun FAN, Yi ZHANG, Xin-hua YANG, Jun JIANG. Relevance between histological and receptor-based subtypes and the response rate after short intensive neoadjuvant chemotherapy in breast cancer patients[J/OL]. Chinese Journal of Breast Disease(Electronic Edition), 2011, 05(03): 283-289.

目的

评价不同组织学类型和受体亚型的乳腺癌患者对新辅助短程密集化疗疗效反应的差异。

方法

对2004 年1 月至2006 年12 月期间在西南医院乳腺疾病中心接受新辅助短程密集化疗的223 例可手术乳腺癌患者资料进行回顾性分析。根据术前粗针穿刺结果,将患者的肿瘤分为雌激素受体(ER)阳性[人表皮生长因子受体(HER-2)阴性]、三阴性以及HER-2 阳性。 新辅助短程密集化疗为4 个周期,化疗方案均为TE(多西紫杉醇 75 mg/m2 d1+ 表柔比星 75m mg/m2 d1),14 d 为1 个周期。 采用χ2 检验分析乳腺癌组织学分类和受体亚型与病理学完全缓解率和化疗有效率的关系。

结果

总的化疗有效率和病理完全缓解(pCR)率分别为59%(132/223)和9%(21/223)。 浸润性导管癌和浸润性小叶癌的化疗有效率分别为70%(122/175)和24%(8/33)(P<0. 01),pCR 率分别为11%(20/175)和3%(1/33)。 ER 阳性、三阴性和HER-2 阳性乳腺癌患者的化疗有效率分别为46%(57/123)、84%(43/51)和65%(32/49)(χ2=22.49,P=0.00),pCR 率分别为2%(3/123)、23%(12/51)和12%(6/49)(χ2=19.39,P=0.00)。

结论

浸润性小叶癌患者从新辅助化疗中获益较小,新辅助化疗后ER 阳性乳腺癌的pCR 率很低。

Objective

To assess the different response between histological and receptor-based subtypes after short intensive neoadjuvant chemotherapy.

Methods

A consecutive series of 223 patients with operable breast cancer treated with short intensive neoadjuvant chemotherapy were analyzed in Breast Diseases Centre of Southwest Hospital between January 2004 to December 2006. Tumors were classified according to their receptor status in estrogen receptor (ER)-positive tumors (HER-2-negative), triple-negative tumors,and HER-2-positive tumors after core-biopsy. All patients received 4 cycles of docetaxel(75 mg/m2d1) plus epirubicin (75m mg/m2 d1) every 14 days. Chi-square test was used to analyze the relation of histological and receptor-based subtypes with pathological complete response (pCR) and chemotherapy response rate.

Results

The overall response rate and pCR rate of intensive neoadjuvant chemotherapy was 59% (132 of 223) and 9% (21 of 223),respectively. In patients with ductal and lobular carcinomas the overall response rate was 70%(122 of 175)and 24%(8 of 33)(P<0.01); and the pCR rate was 11%(20 of 175)and 3%(1 of 33). In ER-positive, triple-negative and HER-2-positive tumors, the overall response rate was 46%(57 of 123), 84%(43 of 51)and 65%(32/49), respectively(χ2=22.49,P=0.00).The pCR rates of ER-positive, triple-negative and HER-2-positive tumors were 2%(3 of 123),23%(12 of 51)and 12%(6 of 49), respectively(χ2 =19. 39,P=0. 00).

Conclusions

In lobular tumors the benefit of short intensive neoadjuvant chemotherapy is limited. the pCR rate of ER-positive tumors is low.

表1 患者的临床资料
表2 不同组织学分类和受体亚型乳腺癌患者的新辅助化疗有效率比较
表3 不同组织学分类和受体亚型乳腺癌患者的新辅助化疗病理完全缓解率比较
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