乳腺癌患者新辅助化疗对雌激素受体表达的影响  

The effect of neo-adjuvent therapy on expression of estrogen receptor

作　　者：朱宁生[1] 邱惠[1] 吕钢[1] 江歌丽[1] 

机构地区：[1]重庆市肿瘤研究所乳腺科,400030

出　　处：《重庆医学》2011年第11期1044-1045,1048,共3页Chongqing medicine

摘　　要：目的探讨新辅助化疗对同一乳腺癌患者雌激素受体(ER)表达的影响,以及ER表达改变后对内分泌治疗效果的影响。方法选择109例可手术的乳腺癌患者,分析术前空芯针穿刺活检标本及术后大体标本癌组织中ER变化。结果 109例中3例患者发生肿瘤重度化疗反应致病理医生判断ER表达困难;3例患者新辅助化疗后达到病理完全缓解,免疫组化无法测定ER,该6例不参与评价。新辅助化疗前、后ER表达的阳性率分别为48.5%(50/103)和51.5%(53/103)。化疗前50例阳性患者中,13例化疗后转为阴性;相反,53例化疗前阴性患者中,16例转为阳性,化疗前、后ER表达的构成比发生了明显变化(P<0.01)。50例化疗前ER表达阳性患者中,轻-中度治疗反应占80.0%(40/50),中-重度治疗反应占20.0%(10/50);53例表达阴性患者中,轻-中度治疗反应占58.5%(31/53),中-重度治疗反应占41.5%(22/53),二者比较差异有统计学意义(P<0.05)。13例ER阳性化疗后转为阴性患者中,轻-中度治疗反应占53.8%(7/13),中-重度治疗反应占46.2%(6/13);16例ER阴性化疗后转为阳性患者中,轻-中度治疗反应占62.5%(10/16),中-重度治疗反应占37.5%(6/16),二者比较,差异无统计学意义(P>0.05)。结论对于临床病例在化疗后出现的ER表达改变,不能作为后继内分泌治疗或化疗的惟一选择依据。Objective To explore the relationship between estrogen receptor expression and treatment response induced by neoadjuvant therapy. Methods Biopsy tissue samples from 109 patients with primary breast cancer were tested for estrogen receptor expression by immunohistochemistry. Results Dramatically down-regulated expression of estrogen receptor occurred in 13 cases, and up-regulated expression took place in 16 patients. The chemical-induced alteration of estrogen expression in breast cancer was not associated with the response of neo-adjuvant treatment. Conclusion The chemical-induced expression of estrogen could not be taken as a guideline for choice of adjuvant or hormone therapy in breast cancer patients.

关 键 词：乳腺肿瘤 受体 雌激素 新辅助化疗 

分 类 号：R737.9[医药卫生—肿瘤]