21基因复发分数对雌激素受体阳性人表皮生长因子受体2阴性腋窝淋巴结阴性早期乳腺癌化疗决策的影响  

Effect of 21-gene recurrence score on chemotherapy decisions for patients with estrogen receptor-positive, epidermal growth factor receptor 2-negative and lymph node-negative early stage-breast cancer

作　　者：毛艳[1] 陈小松[1] 梁跃[1] 吴佳毅[1] 黄欧[1] 宗瑜[1] 方琼[1] 何建蓉[1] 朱丽[1] 陈伟国[1] 李亚芬[1] 林琳[2] 费晓春[3] 沈坤炜[1] 

机构地区：[1]上海交通大学医学院附属瑞金医院乳腺疾病诊治中心,200025 [2]上海交通大学医学院附属瑞金医院检验科,200025 [3]上海交通大学医学院附属瑞金医院病理科,200025

出　　处：《中华肿瘤杂志》2017年第7期502-508,共7页Chinese Journal of Oncology

基　　金：上海市科委重大课题（14411950200、14411950201）;上海申康医院发展中心新兴前沿技术联合攻关项目（SHDC12014103）

摘　　要：目的探讨21基因复发分数（RS）对雌激素受体（ER）阳性、人表皮生长因子受体2（HER－2）阴性和腋窝淋巴结（LN）阴性早期乳腺癌患者辅助化疗决策的影响。方法收集2015年1月至2015年10月行21基因检测、在21基因检测前后行多学科讨论制订辅助治疗方案的148例ER（＋）HER－2（－） LN（－）早期乳腺癌患者的临床病理资料，研究21基因RS对辅助化疗决策的影响。结果21基因检测RS使26例（17.6%）患者的化疗决策发生改变，其中9例患者因21基因检测RS而免于化疗，16例患者由不建议化疗改为化疗，1例患者化疗方案发生改变。多因素分析显示，年龄、组织学分级和21基因RS为影响ER（＋）HER－2（－）LN（－）早期乳腺癌患者化疗决策的独立因素（均P〈0.05）。结论21基因RS可影响ER（＋）HER－2（－）LN（－）早期乳腺癌患者辅助化疗决策的制订。Objective To investigate the effect of 21-gene recurrence score on adjuvant chemotherapy decisions for patients with estrogen receptor （ER） -positive, epidermal growth factor receptor 2 （HER-2）-negative and lymph node （LN）-negative early stage-breast cancer. Methods One hundred and forty-eight patients with ER＋, HER-2- and LN- early stage breast cancer were recruited in the Ruijin hospital, Shanghai Jiao Tong University School of Medicine. The 21-gene recurrence score （RS）assay was performed and systemic therapeutic decisions were made before and after knowing the RS results under muhidisciplinary discussion. The effects of RS assay and the other influential factors on adjuvant chemotherapy decision were further analyzed. Results After knowing the RS resuhs, treatment decisions were changed in 26 out of 148 patients（17.6%）. Among them, 9 out of 26 patients were not recommended for chemotherapy ; 16 of 26 had treatment recommendation changed to chemotherapy, and chemotherapy regimen was changed in the last one patient. Muhivariate analysis showed that RS, age and histological grade were independent factors of decision-making for adjuvant chemotherapy. Conclusion Our results suggest that 21-gene recurrence score significantly influences decision making for adjuvant chemotherapy in patients with ER＋, HER-2- and LN- early stage breast cancer.

关 键 词：乳腺肿瘤 抗肿瘤联合化疗方案 受体 雌激素 受体 表皮生长因子 淋巴结 21基因复发分数 

分 类 号：R737.9[医药卫生—肿瘤]