乳腺癌内分泌治疗耐药的影响因素探讨  

Study on Influencing Factors of Drug Resistance in Endocrine Therapy of Breast Cancer

作　　者：武月升 宋彬[1] WU Yuesheng;SONG Bin(First Hospital of Shanxi Medical University,Shanxi 030001,China)

机构地区：[1]山西医科大学第一医院肿瘤科,太原030001

出　　处：《医学研究杂志》2022年第5期68-73,共6页Journal of Medical Research

基　　金：山西省应用基础研究项目(201601D021170)。

摘　　要：目的探讨乳腺癌内分泌治疗发生耐药的危险因素,并进一步探讨影响不同耐药类型的指标。方法收集2015年1月1日~2016年5月31日就诊于山西医科大学第一医院和山西白求恩医院经辅助内分泌治疗和转移一线内分泌治疗的乳腺癌患者共164例。根据两种治疗方式中患者是否发生耐药分为耐药组和非耐药组,通过Logistic回归分析,探讨影响耐药的危险因素。进一步将发生耐药的患者共64例,根据耐药发生时间分为原发耐药组与继发耐药组,非配对资料组间比较采用χ^(2)检验或Fisher确切概率法,探讨影响耐药类型的指标。结果单因素分析显示,在两种内分泌治疗方式中均表明肿瘤直径、淋巴结分级、体重指数(body mass index,BMI)、雌激素受体(estrogen receptor receptor,ER)、孕激素受体(progesterone receptor,PR)表达水平是影响乳腺癌内分泌治疗发生耐药的相关因素(P<0.05)。多因素分析显示,肿瘤直径、淋巴结分级、ER及PR表达水平是影响耐药的独立危险因素(P均<0.05)。并且在两种治疗方式中,相较于继发耐药者,发生原发耐药者的肿瘤较大(P均<0.05)。结论肿瘤直径、淋巴结分级、ER、PR表达水平是影响内分泌治疗发生耐药的危险因素,并且肿瘤直径在乳腺癌内分泌治疗中对提示发生耐药的类型有重要意义。Objective To explore the risk factors of drug resistance in endocrine therapy of breast cancer,and further explore the indicators that influence different types of drug resistance.Methods A total of 164 breast cancer patients who received adjuvant endocrine therapy and first-line metastatic endocrine therapy in the First Hospital of Shanxi Medical University or the Shanxi Bethune Hospital from January 1,2015 to May 31,2016 were collected.patients were divided into drug resistance group and non-resistance group,Logistic regression analysis was conducted to explore the risk factors affecting drug resistance.Furthermore,There were 64 drug resistance patients were divided into the primary resistance group and the secondary resistance group.Exploring indicators affecting the type of drug resistance using tests or Fisher′s exact probability method.Results Univariate analysis showed that tumor size,lymph node grade,BMI,ER and PR expression levels were all related factors influencing the development of drug resistance to endocrine therapy of breast cancer regardless of treatment mode(all P<0.05).Multivariate analysis showed that,Among the two different treatment modalities,tumor size,lymph node grade,ER and PR expression level were independent risk factors affecting drug resistance(all P<0.05).And the tumor size grade of patients with primary drug resistance was higher than that of patients with secondary drug resistance during the two treatments(all P<0.05).Conclusion Tumor size,lymph node grade,ER and PR expression level are the risk factors for drug resistance in endocrine therapy,and tumor size have important significance in indicating the type of drug resistance in endocrine therapy of breast cancer.

关 键 词：乳腺癌 内分泌治疗 耐药 

分 类 号：R73[医药卫生—肿瘤]