术后辅助化疗对早期乳腺癌保乳根治术患者ER、PR、ERCC1、Ki67、PCNA表达及预后的影响  

Analysis on effect of chemotherapy for early breast cancer radical operation on the patients prognosis and expression of ER, PR, ERCC1, Ki67, PCNA in the postoperative adjuvant

作　　者：戚洪涛 姜涛[2] 

机构地区：[1]黑龙江省齐齐哈尔第一医院普外三科,黑龙江齐齐哈尔161000 [2]哈尔滨医科大学附属第一医院普外五科,黑龙江哈尔滨150000

出　　处：《中国现代普通外科进展》2015年第10期784-787,共4页Chinese Journal of Current Advances in General Surgery

摘　　要：目的:分析术后辅助化疗对早期乳腺癌保乳根治术患者雌激素受体(ER)、孕激素受体(PR)、核苷酸切除修复交叉互补基因1(ERCC1)、Ki67蛋白(Ki67)、增殖细胞核抗原(PCNA)表达及预后的影响,探讨其临床价值。方法:2007年9月—2011年9月107例乳腺癌行早期保乳根治术及术后辅助化疗治疗,观察其治疗前后ER、PR、ERCC1、Ki67、PCNA表达变化及预后。结果:107例患者均获得有效随访,平均随访时间(35.4±1.8)个月。末次随访时无病生存患者92例(86.0%),复发9例(8.4%),死亡6例(5.6%)。患者末次随访时SF-36量表各维度评分均显著升高(P<0.05),其中总体健康、活力、社会功能、情感职能评分升高最为明显(P<0.01)。所有患者化疗期间均出现不同程度的不良反应,以恶心呕吐(100.0%)、脱发(83.2%)为主,多数患者不良反应集中于Ⅰ度、Ⅱ度,不良反应可耐受。患者治疗前、化疗结束时ER、PR阳性率未见明显变化(P>0.05),其ERCC、PCNA阳性率显著下降,Ki67阳性率显著上升(P<0.05)。结论:辅助化疗能够显著降低乳腺癌保乳根治术后患者ERCC、PCNA表达,提高Ki67表达,有效抑制肿瘤的侵袭与转移,具有良好的临床疗效及安全性。Objective： To adjuvant chemotherapy for early breast cancer radical operation on the patients with estrogen receptor （ER） and postoperative analysis of progesterone receptor（PR）, nucleotide excision repair cross complementing 1 （ERCC1） and Ki67 protein （Ki67） and proliferating cell nuclear antigen （PCNA） and the expression of the prognosis, and explore its clinical value. Methods： In 107 cases of breast cancer patients in our hospital from 2007 September ~2011 year in September, the auxiliary Line chemotherapy in the treatment of early breast conserving surgery and postoperative. Observed before and after the treatment of ER, PR, ERCC1, Ki67, PCNA expres- sion and prognosis. Results： 107 patients were followed up. The mean follow-up time （35.4＋ 1.8） months. Disease free survival of 92 patients at the time of the last follow-up （86%）, 9 cases of re- currence （8,4%）, 6 cases of death （5.6%）. The patients at the time of the last follow-up SF-36 scores of dimensions were significantlyincreased CP〈0.05）, the general health, vitality, social func- tion. emotional function score increased most significantly （P〈0.01）. All of the patients during chemotherapy had different degrees of adverse reactions, with nausea and vomiting（100%）, alope- cia（83.2%）, the majority of patients with adverse reactions to I degrees, tl degrees, the adverse re- actions could be tolerated. Patients before treatment, at the end of chemotherapy of ER, the positive rate of PR showed no significant change（P〉＆05）, the ERCC. the positive rate of PCNA was signifi- cantly decreased, the positive rate of Ki67was significantly increased （P〈0.05）, Conclusion： Ad- juvant chemotherapy can significantly reduce the expression of ERCC, PCNA in patients with breast cancer after radical operation, enhance the expression of Ki67, inhibit the invasion and metastasis of tumor, has good clinical efficacy and safety, broad 0rospect of clinical application.

关 键 词：乳腺癌 辅助化疗 保乳根治术 雌激素受体 孕激素受体 预后 核苷酸切除修复交叉互补基因1 KI67蛋白 增殖细胞核抗原 

分 类 号：R737.9[医药卫生—肿瘤]