乳腺癌中医辨证分型对新辅助化疗疗效及预后的影响  

Influence of Chinese Medicine Syndrome Differentiation on Curative Effect of Neoadjuvant Chemotherapy and Prognosis in Breast Cancer

作　　者：岑东芝[1] 丛鹏[1] 全天一[1] 罗超元[1] 冯智毅[1] 

机构地区：[1]广州医科大学附属第三医院,广东省广州市多宝路63号510150

出　　处：《中医杂志》2016年第10期856-859,共4页Journal of Traditional Chinese Medicine

基　　金：广州市中医药中西医结合科研项目(20122A011032)

摘　　要：目的探讨乳腺癌中医辨证分型与新辅助化疗敏感性及预后的关系。方法选择161例初发需行新辅助化疗的女性乳腺癌患者,其中肝郁痰凝证120例,冲任失调证38例,正虚毒炽证3例。所有患者接受2~6周期ET方案新辅助化疗,化疗结束2周内行手术治疗,术后常规评估病理疗效并检测肿瘤组织中雌激素受体（ER）、孕激素受体（PgR）和人表皮生长因子受体2（HER2）阳性表达情况,对不同证型患者病理疗效及无疾病生存时间（DFS）进行比较。结果肝郁痰凝证患者ER阳性率为64.1%,高于冲任失调证患者的44.7%（P=0.035）,两个证型患者年龄、临床分期、组织学分级、PgR和HER2状态方面比较差异无统计学意义（P〉0.05）。肝郁痰凝证患者病理完全缓解率为16.7%,明显低于冲任失调证患者的31.6%（P=0.046）。肝郁痰凝证患者的DFS长于冲任失调证患者（P=0.034）,在ER阳性患者中肝郁痰凝证患者的DFS也长于冲任失调证患者（P〈0.05）。结论乳腺癌肝郁痰凝证患者的新辅助化疗病理完全缓解率低,但DFS高,其分子机制可能与ER状态相关。Objective To study the relation between Chinese Medical types of syndrome differentiation in Breast Cancer and sensibility of neoadjuvant chemotherapy and prognosis. Methods A total of 161 women with incipient breast cancer who required neoadjuvant chemotherapy were chosen for the study,including 120 cases with liver depression to phlegm stagnation syndrome,38 cases with imbalance of Chong and Ren Channels syndrome,and 3cases with weakened body resistance and serious toxin. All patients received ET scheme of neoadjuvant chemotherapy for 2 ~ 6 cycle. Within two weeks after chemotherapy,the patients received surgery. After surgery the pathological curative effect was routinely assessed and positive expression of estrogen receptor（ ER）,progesterone receptor（ PgR）and human epidermal growth factor receptor 2（ HER2） in tumor tissue were detected. The pathological curative effect and duration of disease free survival（ DFS） in patients with different syndrome types were compared. Results Rate of positive ER in the patients with liver depression to phlegm stagnation syndrome was 64. 1%,higher than44. 7% in the patients with imbalance of Chong and Ren Channels syndrome（ P = 0. 035）. There was no statistically significant difference between patients with the two respectively syndrome types in age,clinical stage,histological grade and condition of PgR and HER2（ P 〉 0. 05）. Pathologic complete catabatic rate in the patients with liver depression to phlegm stagnation syndrome was 16. 7%,significantly less than 31. 6% in the patients with imbalance of Chong and Ren Channels syndrome（ P = 0. 046）. DFS of the patients with liver depression to phlegm stagnation syndrome was longer than that of the patients with imbalance of Chong and Ren Channels syndrome（ P = 0. 034）,the same in the patients with positive ER（ P 〈 0. 05）. Conclusion Pathologic complete catabatic rate about neoadjuvant chemotherapy in patients with breast cancer and liver depression to phlegm stagnation syndrome was low,but t

关 键 词：乳腺癌 新辅助化疗 辨证分型 雌激素受体 无疾病生存时间 

分 类 号：R737.9[医药卫生—肿瘤]