晚期乳腺癌ER和HER-2表达状态与TE方案化疗近期有效率的相关性研究  

Association of the ER and HER-2 Expression Status with the Short-term Effect of Paclitaxel and Epirubicin Chemotherapy in Advanced Breast Cancer

作　　者：汪青[1] 鞠放[1] 王宁[1] 王雅杰[1] 

机构地区：[1]上海第二军医大学附属长海医院肿瘤科,200433

出　　处：《医学研究杂志》2010年第4期22-25,共4页Journal of Medical Research

基　　金：上海市科学技术委员会科研计划资助项目(06DZ19505)

摘　　要：目的研究晚期乳腺癌不同的ER和HER-2表达状态与多西紫杉醇联合表柔比星的姑息化疗近期有效率的相关性。方法对经多西他赛联合表柔比星治疗的42例晚期乳腺癌患者进行回顾性分析,利用既往免疫组化资料,将患者分为4个亚组:ER+,HER-2-组;ER+,HER-2+组;ER-,HER-2-组;ER-,HER-2+组,结合患者的临床病理学资料,观察TE方案近期有效率(RR)的影响因素及化疗不良反应。结果全组42例患者均完成至少两周期化疗,并行疗效评价。该组患者TE方案化疗的近期有效率为23例(54.8%),RR与不同的转移病灶部位(P=0.038)及病灶数目(P=0.036)有显著差异。该方案的毒性不良反应主要为脱发36例(85.7%),骨髓抑制29人(69.1%),周围神经炎10例(23.9%)。不同ER、HER-2表达的亚组与RR呈线性趋势分布(P=0.027),ER-,HER-2+组患者的RR值(83.3%)高于ER+,HER-2-组(25.6%)(P=0.045)。结论 ER-,HER-2+的晚期乳腺患者对TE方案化疗方案更敏感,ER和HER-2表达状态是该方案疗效的预测指标,联合考察ER和HER-2的表达状态可能有助于选择合理的化疗方案。ObjectiveTo explore the correlation of the ER and HER-2 expression status with the short-term effect of paclitaxel and epirubicin （TE） chemotherapy advanced breast cancer. MethodsPast Immunohistochemical data of 42 advanced breast cancer patients after paclitaxel combined epirubicin treatment were analyzed retrospectively. Patients were divided into four sub-groups： ER ＋, HER-2-group; ER ＋, HER-2 ＋ group; ER-, HER-2-group; ER-, HER-2 ＋ group. All affecting patients with complete clinical and pathological data were observed for the factors short-term effect of TE chemotherapy and for chemotherapy adverse. Results The whole 42 patients completed at least two cycles of chemotherapy, and then got efficacy evaluation. Recent response rate of the patients who got TE chemotherapy was 23 cases （54.8%）.RR with different metastatic sites （P=0.038） and the number of metastasis （P=0036） were significantly different. The mainly adverse events of chemotherapy were alopecia for 36 cases （85.7%）, myelosuppression for 29 cases （69.1%）, Peripheral neuritis for 10 cases （23.9%）. ER,HER-2 expression in the Different sub-groups and the RR showed linear distribution （P= 0.027）.RR values （83.3%） in patients of ER-, HER-2 ＋ group was significantly higher than that of the ER ＋, HER-2-group （25.6%） （P=0.045）. ConclusionAdvanced breast cancer patients with ER-, HER-2 ＋ were more sensitive to TE chemotherapy.ER and HER-2 expression status was a predictor of efficacy of the chemotherapy. It may be helpful to consider ER and HER-2 expression status in choosing reasonable chemotherapy.

关 键 词：乳腺肿瘤 多西紫杉醇 表柔比星 雌激素受体 HER-2基因 

分 类 号：R[医药卫生]