乳腺癌转移病灶再活检对于指导治疗的价值  

Value of biopsy of metastatic lesions for guiding therapy in breast cancer patients

作　　者：张俊[1] 瞿晴[2,3] 费晓春[4] 陈小松[3] 任若冰[2] 徐昊平[2] 许赪[2] 沈坤炜[3] 

机构地区：[1]上海交通大学医学院附属瑞金医院普外科,上海200025 [2]上海交通大学医学院附属瑞金医院肿瘤放化疗科,上海200025 [3]上海交通大学医学院附属瑞金医院乳腺疾病诊治中心,上海200025 [4]上海交通大学医学院附属瑞金医院病理科,上海200025

出　　处：《诊断学理论与实践》2013年第3期304-308,共5页Journal of Diagnostics Concepts & Practice

摘　　要：目的:探讨乳腺癌原发病灶和转移病灶中雌激素受体(estrogen receptor,ER)、孕激素受体(progesteronereceptor,PR)、人类表皮生长因子受体-2(human epidermal growth factor receptor 2,HER-2)状态的变化,评价乳腺癌转移病灶活检对于治疗方式选择的价值。方法:均行转移灶再活检并经病理检查结果证实的41例乳腺癌术后转移患者,采用免疫组化和(或)荧光原位杂交(FISH)法检测其转移灶中ER、PR、HER-2的状态。结果:41例患者的转移灶与原发灶中ER、PR、HER-2状态不一致率分别为21.9%、26.8%和9.8%,转移灶的再活检导致31.7%的患者治疗方案发生变化。结论:乳腺癌转移病灶的再活检可明确转移灶的激素受体及HER-2状态变化,以指导患者的下一步治疗方案。Objective： To identify the ER （estrogen receptor）, PR （progesterone receptor）, HER-2 （human epidermal growth factor receptor 2） status in primary and metastatic breast cancer lesions, and assess the value of re-biopsy of metastatic lesion for guiding therapy in patients with metastatic breast cancer. Methods： Forty-one patients with pathologically confirmed metastatic breast cancer were enrolled. The ER, PR, HER-2 status were assessed by IHC and/or FISH using core needle aspiration or resection specimen. Results： The discordance rates of ER, PR, HER-2 status between primary and metastatic lesions were 21.9%, 26.8% and 9.8%, respectively. Therapeutic strategy was changed in 31.7% patients based on the re-biopsy of metastatic lesion. Conclusions： The re-biopsy of metastatic lesion to identify ER, PR, HER-2 status could be used to guide the therapeutic regimen for metastatic breast cancer patient.

关 键 词：乳腺癌 复发 转移 再活检 

分 类 号：R737.9[医药卫生—肿瘤]