新疆维吾尔族女性乳腺癌新辅助化疗疗效多因素分析  

Multi-factor analysis of response to neo-adjuvant chemotherapy in Xinjiang Uyghur females with breast cancer

作　　者：何益腾 宋牧[1] 陈晶[1] 于冰[1] 朱丽萍[2] 

机构地区：[1]新疆医科大学第二附属医院肿瘤外科,新疆乌鲁木齐830063 [2]新疆医科大学肿瘤医院乳腺外科,新疆乌鲁木齐830011

出　　处：《海南医学》2015年第7期963-966,共4页Hainan Medical Journal

摘　　要：目的探讨相关因素在新疆地区维吾尔族女性乳腺癌新辅助化疗（NAC）疗效中的意义。方法收集新疆医科大学第二附属医院及肿瘤医院2010年1月至2014年6月87例行NAC的维吾尔族女性乳腺癌患者的全部病历资料。NAC前均行肿块空心针穿刺活检病理确诊,并用免疫组化（IHC）方法明确患者雌激素受体（ER）、孕激素受体（PR）、人表皮生长因子受体2（Her-2）状态和肿瘤增殖指数（Ki-67）。分析患者年龄、绝经状态、体质指数（BMI）、肿块大小、腋窝淋巴结状况、临床分期、NAC周期数、分子分型对NAC有效率（CR＋PR）和病理完全缓解（p CR）的预测作用。结果在87例患者中NAC总有效率为85.06%（74/87）,疾病稳定（SD）率为11.49%（10/87）,疾病进展（PD）率为3.45%（3/87）;p CR率为14.94%（13/87）。激素受体阴性、Ki-67指数〉20%、体重指数（BMI）〈25 kg/m^2、非Lumina A型患者NAC疗效更好。NAC周期数〉4个周期为预测p CR的独立变量（P=0.004,OR=0.081;95%CI：0.015~0.441）。结论 ER阴性、PR阴性、NAC周期〉4个周期者p CR率更高。ER阴性、PR阴性、Ki-67指数〉20%、非Lumina A型、BMI〈25 kg/m^2者NAC后临床有效率更高。NAC周期〉4周期为预测p CR的独立因素。Objective To assess the influencing factors of response to neoadiuvant chemotherapy （NAC） in Xinjiang Uighur females with breast cancer. Methods The clinical data of 87 Xinjiang Uighur females with breast cancer undergoing NAC from January 2010 to June 2014 were retrospectively studied. Estrogen receptor （ER）, proges-terone receptor （PR）, human epidermal growth factor receptor 2 （Her-2）, proliferation index of Ki-67 were investigat-ed by immunohistochemistry. The role of age, menopausal status, body mass index （BMI）, tumor size, axillary lymph node status, clinical stage, number of NAC cycles, molecular subtype for evaluating pathological complete response （pCR） rate and clinical effective rate [complete response （CR）＋partial response （PR）] were analyzed. Results After NAC, the total clinical effctive rate （CR＋PR） was 85.06%（74/87）, with stable disease （SD） rate of 11.49%（10/87）, progressive disease （PD） rate of 3.45%（3/87）, pCR rate of 14.94%（13/87）. The clinical effective rate （CR＋PR） was associated with the expression of hormone receptor （ER and PR）, Ki-67 index and molecular subtype：the clinical effi-cacay was better with HR negative, high Ki-67 index （〉20%）, BMI〈25 kg/m^2, non-luminal A than HR positive, low Ki-67 index （〈20%）, BMI≥25 kg/m^2, luminal A. NAC cycles〉4 cycles was an independent factor for predicting pCR after NAC （P=0.004, OR=0.081;95%CI：0.015~0. 441）. Conclusion Patients with hormone receptor negative （ER, PR）, high Ki-67 index （〉20%）, non-luminal A, BMI〈25 kg/m^2 have a higher clinical effective rate （CR＋PR）. The pCR rate is higher with hormone receptor nagative, NAC cycles〉4 cycles, and NAC cycles〉4 cycles is an independent factor for predicting pCR after NAC.

关 键 词：新疆地区 维吾尔族 乳腺癌 新辅助化疗 病理完全缓解 

分 类 号：R737.9[医药卫生—肿瘤]