局部晚期乳腺癌分子亚型与新辅助化疗疗效关系的研究  

Study on relationship between molecular subtypes of locally advanced breast cancer and neoadjuvant chemotherapy

作　　者：张一聪[1] 王本忠[1] 张敬杰[1] 任敏[1] 王劲[1] 裴静[1] 徐晓军[1] 

机构地区：[1]安徽医科大学第一附属医院乳腺外科,安徽230022

出　　处：《中华内分泌外科杂志》2010年第5期299-302,306,共5页Chinese Journal of Endocrine Surgery

摘　　要：目的 探讨四种不同乳腺癌分子亚型对多西他赛联合蒽环类对局部晚期乳腺癌患者新辅助化疗疗效的预测价值.方法 对该新辅助化疗方案治疗68例局部晚期乳腺癌患者的资料进行回顾性研究.通过免疫组化法（IHC）将空芯针穿刺活检确诊的乳腺癌分为四种分子亚型.评价3～5个疗程后的疗效,分析其与乳腺癌分子亚型之间的相关性.结果 对各指标单因素分析发现,雌激素受体（ER）阴性、原发肿瘤大小≤5cm可预测该新辅助化疗方案的临床完全缓解（cCR）（P＜0.05）.HER-2过表达及分子亚型可预测其病理完全缓解（pCR）（P＜0.05）.其中,HER-2＋/ER-型对该方案的pCR率明显高于其他三种分子亚型,Luminal A型所达的pCR率最低.但多因素分析未能进一步肯定乳腺癌分子亚型对该新辅助化疗方案的预测价值（P＞0.05）.仅HER-2独立地与其pCR密切相关（P＜0.05）.结论 乳腺癌分子亚型尚不能作多西他赛加蒽环类联合方案新辅助化疗pCR的独立预测指标.Objective To explore the relationship between the four different molecular subtypes of locally advanced breast cancer（LABC） and the clinical effect of neoadjuvant chemotherapy containing docetaxel and anthracyclines on breast cancer. Methods The record of 68 patients with LABC who were treated with the therapeutic scheme was reviewed. Breast cancer molecules were diagnosed by core needle biopsy through IHC and were divided into four subtypes. After 3 to 5 courses of treatment, the relationship of molecular subtype and clinical effects was analyzed. Results Univariate analysis showed that absence of estrogen receptor （ER） expression and size of tumor （≤5cm） were predictive factors for clinical complete response （cCR） （P〈0.05）.Over expression of HER-2 and molecular subtypes were predictive for pathologic complete response （pCR） （P〈0.05）. pCR rate of HER2＋/ER- subtype in this therapeutic scheme was, higher than that of other subtypes and pCR rate of Luminal A subtype was the lowest. Multivariate analysis showed that molecular subtypes cant be the predictive factors for this therapeutic scheme （P〉0.05） and only HER-2 （P〈0.05） was the independent variable in predicting pCR for this therapeutic scheme. Conclusion Molecular subtypes can not independently predict pCR for neoadjuvant chemotherapy regimen containing docetaxel and anthracyclines.

关 键 词：乳腺癌 新辅助化疗 分子亚型 预测指标 

分 类 号：R737.9[医药卫生—肿瘤]