基于分子分型的早期乳腺癌保乳治疗的疗效分析  

Therapeutic effect analyse of early breast conserving therapy for breast carcinomas classified based on molecular classification

作　　者：乔广东[1] 朱世光[1] 林骏[1] 邹海东[1] 

机构地区：[1]山东省烟台毓璜顶医院乳腺外科,264000

出　　处：《中国实用医药》2013年第17期40-41,共2页China Practical Medicine

摘　　要：目的探讨早期乳腺癌保乳治疗在不同分子分型之间的疗效和适用性。方法按肿瘤组织免疫组化ER、PR、HER-2等表达情况将本院收治200例乳腺癌进行分子分型;所有患者均行早期乳腺癌保乳术治疗,术后按NCCN指南进行全身综合治疗并进行随访,对比各分子分型患者的生存质量、局部复发率及总生存率。结果 LuminalA型患者的生存率和平均生存质量显著高于其他各组(P<0.05),局部复发率显著低于其他各分型(P<0.05);LuminalB型患者的生存率和平均生存质量显著高于HER-2过表达型和三阴型(P<0.05),局部复发率显著低于HER-2过表达型和三阴型(P<0.05);HER-2过表达型和三阴型疗效最差,两者之间无显著差异(P>0.05)。结论早期保乳术治疗在不同分子亚型的乳腺癌患者之间疗效不同。对于LuminalA型患者疗效最为显著,适用性最强;对于LuminalB型患者,疗效和适用性尚可取得较满意效果。HER-2过表达型和三阴型疗效及适用性都较差,其中HER-2过表达型患者在靶向治疗的基础上可能取得更佳效果;而三阴型患者疗效最差,可能并不适用于保乳治疗,可行彻底根治术或其他综合疗法。Objective To explore the curative effect and applicability of early breast conserving therapy between different molecular classification of breast carcinoma. Methods 200 cases of breast cancer treated in our hospital were classified according to the expression of ER, PR and HER-2 assessed by immunohistochemistry. All patients were treated with early breast conserving therapy and given postoperative systemic comprehensive treatment according to NCCN guidelines after which the local recurrence rate, survival quality, and overall survival rate were respectively compared. Results The Luminal A type survival rate and quality of life were significantly higher than other groups （P〈0.05）, while the local recurrence rate was significantly lower than other type （P 〈 0.05）; Luminal B type average survival rate and quality of life were significantly higher than HER-2 expression type and three negative type （P〈O.05）, while the local recurrence rate was significantly below the HER-2 expression type and three negative type （P〈O.05）; HER-2 overexpression type and three negative type had worst curative effect and without significant difference （P〉0.05） between two groups. Conclusion There is difference in the curative effect of early breast conserving surgery for different molecular subtypes of breast cancer patients. For patients with type Luminal A, the effect in the most significant and the applicability is also best; For patients with type Luminal B, the curative effect and the applicability could also be obtained satisfied; Patients with HER-2 overexpression type may also achieve a better effect on the basis of targeted therapy; And curative effect is worst for patients with three negative type, which may be not applied to early breast conserving treatment, and more feasible for other comprehensive or radical therapy.

关 键 词：乳腺癌保乳治疗 分子分型 疗效分析 

分 类 号：R737.9[医药卫生—肿瘤]