血清肝细胞生长因子对Ⅱ/Ⅲ期乳腺癌新辅助化疗疗效及预后的影响  

Impact of serum hepatocyte growth factor on response to neoadjuvant chemotherapy and prognosis in patients with stage Ⅱ / Ⅲ breast cancer

作　　者：赵华洲[1] 王婷[2] 张心慧[1] 刘瑞军[1] 曹志宇[1] 杨波[1] 何建苗[1] Zhao Huazhou;Wang Ting;Zhang Xinhui;Liu Ruijun;Cao Zhiyu;Yang Bo;He Jianmiao(Department of General Surgery, No. 309 Hospital of PLA, Beijing 100091, China;Department of Medical Affairs, Beijing Chaoyang Hospital, Capital Medical University,Beijing 100020, China)

机构地区：[1]解放军第309医院普通外科,北京100091 [2]首都医科大学附属北京朝阳医院医务处,100020

出　　处：《中华乳腺病杂志（电子版）》2016年第6期353-357,共5页Chinese Journal of Breast Disease(Electronic Edition)

摘　　要：目的探讨血清肝细胞生长因子(HGF)与乳腺癌临床病理特征及新辅助化疗(NAC)疗效间的关系。方法回顾性收集2010年1月至2015年1月168例于解放军第309医院因Ⅱ/Ⅲ期乳腺癌行新辅助化疗的患者资料,采用ELISA法检测患者血液样本中HGF浓度,统计分析血清HGF水平中位值,将血清HGF高于中位值患者设为高水平(H)组(n=84),血清HGF低于中位值患者设为低水平(L)组(n=84)。依据实体瘤治疗疗效评价(RECIST)标准评估患者接受NAC的疗效。患者术后随访时间2~68个月,制作患者生存曲线。采用字2检验比较2组患者临床分期、肿瘤直径、淋巴结转移、ER、PR及HER鄄2状态间的差异,采用t检验比较2组患者组织多肽特异性抗原(TPSA)、糖链抗原(CA)15-3、Ki67间的差异,采用Kaplan-Meier法分析血清HGF水平与NAC疗效、5年累积生存率及5年DFS的差异的关系,采用Cox比例风险回归模型分析影响5年累积生存率的风险因素。结果患者血清HGF中位值为825pg/ml。H组淋巴结转移率为48.8%(41/84)、血清TPSA为(60.6依26.8)U/L,高于L组的30.9%(26/84)(字2=5.586,P=0.018)和(49.8依20.9)U/L(t=-2.930,P=0.004)。Kaplan-Meier法提示H组化疗有效率为69.0%(58/84)、5年DFS为65.5%、5年累积生存率分别为69.0%,低于L组的84.5%(71/84)(字2=5.643,P=0.018)、81.9%(字2=4.957,P=0.046)和89.9%(字2=4.849,P=0.044)。Cox比例风险回归模型分析提示血清HGF水平、临床分期及NAC疗效是影响5年累积生存率的风险因素(HR=7.0,95%CI=1.28~47.62,P=0.037;HR=8.5,95%CI=3.55~29.79,P=0.006;HR=4.8,95%CI=1.84~7.99,P=0.024)。结论摇血清HGF水平与乳腺癌淋巴结转移、NAC疗效及预后密切相关,可作为预测NAC疗效和预后的指标。Objective To explore the relationship of serum hepatocyte growth factor(HGF)with the efficacy of neoadjuvant chemotherapy(NAC)and clinicopathological characteristics in patients with stageⅡ/Ⅲbreast cancer.Methods Totally168patients with stageⅡ/Ⅲbreast cancer who underwent neoadjuvant therapy between January2010and January2015in No.309Hospital of PLA were enrolled for a retrospective study.They were divided into2groups,including low HGF level(L)group(n=84)and high HGF level(H)group(n=84)according to the median value of serum HGF,which was detected by ELISA and calculated by statistical analysis.The efficacy of NAC was assessed according to the RECIST criteria.The patients were followed up for2-68months and the survival curves were drawn.The differences in clinical stage,tumor size,lympho node metastasis,ER,PR and HER-2expression between two groups were analyzed by x2test.The differences in tissue polypeptide specific antigen(TPSA),carbohydrate antigen(CA)15-3,Ki67were analyzed by t test.Kaplan-Meier method was used to analyze the relationship of serum HGF level with efficacy of NAC,5-year DFS and5-year cumulative survival.Risk factors associated with5-year cumulative survival were processed in Cox’s proportional hazards regression model.

关 键 词：肝细胞生长因子 乳腺肿瘤 抗肿瘤联合化疗方案新辅助化疗 淋巴转移 无病生存 

分 类 号：R737.9[医药卫生—肿瘤]