三阴性乳腺癌新辅助化疗后淋巴结阴性原发灶癌残留的影响因素分析  

Influencing factors analysis of lymph node-negative patients with primary tumor residue after neoadjuvant chemotherapy of triple negative breast cancer

作　　者：韩忠华[1] 林舜国[1] 许春森[1] 韩晖[1] 

机构地区：[1]福建医科大学附属协和医院乳腺外科,福建福州350000

出　　处：《中国现代医生》2017年第34期81-83,87,共4页China Modern Doctor

摘　　要：目的探讨三阴性乳腺癌新辅助化疗后淋巴结阴性原发灶癌残留的影响因素。方法回顾性分析福建医科大学附属协和医院乳腺外科2014年1月~2017年1月收治的三阴性乳腺癌新辅助化疗后淋巴结阴性者129例,其中伴原发灶癌残留者75例,新辅助治疗方案为蒽环类+紫杉类,化疗后均行乳腺癌改良根治术。采用Logistic回归多因素分析,探讨化疗后淋巴结阴性原发灶癌残留的危险因素。结果单因素分析显示,新辅前T分期>T3、化疗周期>4、新辅前Ki67>14%和脉管瘤栓阳性均是原发灶癌残留的危险因素(P<0.05)。Logistic回归分析显示,化疗周期>4、新辅前Ki67>14%和脉管瘤栓阳性是化疗后原发灶癌残留的独立危险因素。结论三阴性乳腺癌新辅助化疗尽量予以术前足疗程完成,术后淋巴结阴性原发灶癌残留者可参考新辅前Ki67和脉管瘤栓等高危因素,考虑强化局部或者全身治疗。Objective To investigate the influencing factors of lymph node-negative patients with primary tumor residue after neoadjuvant chemotherapy of triple negative breast cancer. Methods A total of lymph node-negative 129 patients after neoadjuvant chemotherapy of triple negative breast cancer admitted in the Department of Breast Surgery of Fujian Medical University Union Hospital from January 2014 to January 2017 were retrospectively analyzed. Among them, there were 75 cases with residual primary tumor. The new adjuvant treatment was anthracyclines＋taxanes, and the patients were all treated with modified radical mastectomy of breast cancer. Logistic regression multivariate analysis was used to explore the risk factors of lymph node-negative patients with primary tumor residue after chemotherapy. Results Univariate analysis showed that pre-nodulation T-stage〉T3, chemotherapy cycle〉4, pre-neoadjuvant chemothera- py Ki67〉14% and the positive of tumor thrombosis were the risk factors of residual primary tumor （P〈0.05）. Logistic regression analysis showed that the chemotherapy cycle〉4, Ki67〉14% before neoadjuvant chemotherapy and the positive of tumor thrombus were independent risk factors of residual primary tumor after chemotherapy. Conclusion Neoadjuvant chemotherapy for triple-negative breast cancer should be finished with preoperative full course of treatment. Patients with lymph node-negative and residual primary tumor may be treated locally or by systemic treatment with reference to risk factors such as Ki67 and tumor thrombosis before neoadjuvant chemotherapy.

关 键 词：三阴性乳腺癌 新辅助化疗 淋巴结阴性 影响因素 

分 类 号：R737.9[医药卫生—肿瘤]