Luminal B型乳腺癌新辅助化疗效果与影响因素分析  

Neoadjuvant chemotherapy effect and influencing factors on Luminal B breast cancer

作　　者：仉玮[1] 赖米林[1] 杨时鸿[2] 任黎萍[1] 

机构地区：[1]广东省中医院乳腺科,广东广州510120 [2]广东省中医院芳村医院急诊科,广东广州510370

出　　处：《广东医学》2017年第22期3426-3429,3432,共5页Guangdong Medical Journal

基　　金：广东省中医药局建设中医药强省科研课题(编号:20151226)

摘　　要：目的探讨不同亚型Luminal B型乳腺癌新辅助化疗的效果及病理完全缓解(p CR)的影响因素,为临床干预及预后评估提供参考。方法采用回顾性调查方法,收集行新辅助化疗的Luminal B型乳腺癌患者148例,以HER2表达情况分为HER2阴性亚型与HER2阳性亚型,采用X^2检验分析两组新辅助化疗的效果;以是否pCR分为pCR组及非p CR组,采用X^2检验及非条件逐步logistic回归分析影响因素。结果在148例患者中,HER2阴性亚型93例,HER2阳性亚型55例,两组治疗方案、治疗周期、pCR率的差异有统计学意义(P<0.05);p CR组14例(HER2阴性亚型5例,HER2阳性亚型9例),非pCR组134例;影响pCR的因素有:雌激素受体(ER)状态、HER2状态、Ki67指数(P<0.05)。结论 Luminal B型HER2阳性亚型乳腺癌的新辅助化疗反应性好于HER2阴性,在治疗有效的前提下可适当延长化疗周期以提高p CR率。ER阴性或低表达、HER2阳性、Ki67高表达对新辅助化疗疗效具有一定的预测价值。Objective To investigate the effect of neoadjuvant chemotherapy （NAC） and the influencing factors on pCR of Luminal B breast cancer of different subtypes, and to provide references for clinical intervention and prognosis evaluation. Methods In the retrospective study, the clinical materials of 148 Luminal B breast cancer patients with NAC were collected from November 2010 to July 2016. According to the expression of human epidermal growth factor receptor2 （HER2）, they were divided into HER2 negative and HER2 positive subtypes. They were also divided into pCR and non - pCR groups. The chi -square test and logistic regression were applied for analysis. Results Among the 148 patients, HER2 negative subtype （ n = 93） and HER2 positive subtype （ n = 55） significantly differed in treatment regimens, treatment cycles and pCR rate （ P 〈 0. 05 ） ; there were 14 patients in pCR group （ 5 of HER2, negative subtype, and 9 of HER2 positive subtype）, and 104 in non -pCR group. The pCR was significantly affected by ER status, HER2 status and Ki67 index （P 〈 0. 05）. Conclusion The response to NAC of Luminal B breast cancer HER2 positive subtype is better than that of HER2 negative. With the effective treatment, NAC cycles can be prolonged to increase likelihood of pCR. ER negative or low expression, HER2 positive and high expression of Ki67 have some predictive values on the effect of NAC.

关 键 词：LUMINAL B型乳腺癌 新辅助化疗 疗效 影响因素 

分 类 号：R737.9[医药卫生—肿瘤]