内分泌治疗在乳腺癌原发灶激素受体阴性而腋窝淋巴结转移灶激素受体阳性患者中的疗效  

Therapeutic effect of endocrine therapy in breast cancer patients with negative hormone receptor of primary lesion and positive hormone receptor of metastatic axillary lymph node lesion

作　　者：郑向欣[1] 吴骥[1] 顾书成 江小玲[2] 侍孝红[2] 袁牧[1] 陆柏林[1] 邱兴[1] 张旭旭[1] 柏建印 管小青[1] 

机构地区：[1]南京鼓楼医院集团宿迁市人民医院乳腺外科,江苏宿迁223800 [2]南京鼓楼医院集团宿迁市人民医院病理科,江苏宿迁223800

出　　处：《中国普外基础与临床杂志》2018年第2期161-165,共5页Chinese Journal of Bases and Clinics In General Surgery

基　　金：江苏省青年医学人才资助课题(项目编号:QNRC2016490);宿迁市社会发展科技支撑资助课题(项目编号:S201610)

摘　　要：目的探讨内分泌治疗在乳腺癌原发灶激素受体(HR)阴性(HR~–)而腋窝淋巴结转移灶HR阳性(HR^+)患者中的疗效。方法纳入2011年1月至2016年1月期间笔者所在医院收治的67例原发灶HR~–而腋窝淋巴结转移灶HR^+乳腺癌患者,随机分为内分泌治疗组(33例)和对照组(34例),内分泌治疗组患者放化疗结束后口服三苯氧胺,2次/d,10 mg/次,5年;对照组放化疗结束后未予口服三苯氧胺。比较2组患者的生存情况。结果内分泌治疗组和对照组患者的年龄、月经情况、肿瘤直径、术前TNM分期等方面比较差异均无统计学意义(P>0.05)。所有患者均获随访,随访时间12~60个月,中位随访时间48.5个月。内分泌治疗组患者的复发率、转移率及复发转移死亡率与对照组比较差异均无统计学意义(P>0.05)。内分泌治疗组患者的3、5年无病生存率及总生存率均明显高于对照组(P<0.05),内分泌治疗组患者5年累积无病生存和累积总生存效果也均明显优于对照组(P<0.05)。结论重视乳腺癌患者原发灶与腋窝淋巴结转移灶的分子分型,内分泌治疗或许可以提高原发灶HR~–而腋窝淋巴结转移灶HR^+乳腺癌患者的生存率。Objective To explore therapeutic effect of endocrine therapy in breast cancer patients with negative hormone receptor （HR-） of primary lesion and positive HR （HR＋） of metastatic axillary lymph node lesion. Methods Sixty- seven cases of breast cancer with HR- of primary lesion and HR~ of metastatic axillary lymph node lesion from January 2011 to January 2016 were selected. All the patients were randomly divided into endocrine therapy group （33 cases） and control group （34 cases）. The patients were given the oral drug oftamoxifen on the basis of conventional chemotherapy in the endocrine therapy group after the surgery, 10 mg/time, twice daily, 5 years; while the patients in the control group were not given the oral drug of tamoxifen but the other therapy same as the endocrine therapy group. The survivals were compared in both groups. Results There were no significant differences in the age, menstrual condition, tumor diameter, preoperative TNM stage, and so on between the endocrine therapy group and the control group （P〉0.05）. All the patients were followed up for 12-60 months with a 48.5 months of median time. There were no significant differences in the rates of the local recurrence and metastasis, or death rate due to the recurrence and metastasis in both groups （P〉0.05）. The progression-free survival and overall survival in the endocrine therapy group were significantly higher than those in the control group （P〈0.05）. The 5-year cumulative progression-free survival and overall survival in the endocrine therapy group were significantly better than those in the control group （P〈0.05）. Conclusion Pay attention to molecular classification of primary lesion and metastatic axillary lymph node lesion in patients with breast cancer, and endocrine therapy might be able to improve survival rate of breast cancer patients with primary lesion HR- and metastatic axillary lymph node lesion HR^＋.

关 键 词：乳腺癌 分子分型 雌激素 孕激素 内分泌治疗 

分 类 号：R737.9[医药卫生—肿瘤]