21基因检测在ER阳性早期乳腺癌术后辅助化疗中的作用研究  

Role of 21 gene detection in postoperative adjuvant chemotherapy for ER-positive early breast cancer

作　　者：卜烨 陈园[1] 安丽颖[1] 张晨洁[2] BU Ye;CHEN Yuan;An Liying;ZHANG Chenjie(General Surqeny Department of the Second Central Hospital of Baoding City,Baoding 072750,China)

机构地区：[1]河北省保定市第二中心医院普外科,072750 [2]河北省保定市第二中心医院肾内科,072750

出　　处：《中国煤炭工业医学杂志》2023年第6期593-597,共5页Chinese Journal of Coal Industry Medicine

基　　金：河北省医学科学研究重点课题计划(编号:20181495)。

摘　　要：目的分析21基因检测在ER阳性早期乳腺癌术后辅助化疗中的作用。方法选取2020年4月—2022年4月,在该院接受乳腺癌手术治疗的90例女性患者,患者在术后的病理检测中为ER阳性、淋巴结阴性,采用免疫组化法检测细胞核相关抗原(Ki-67)、雌激素受体(ER)表达;采用分支DNA-液相芯片技术检测21基因。结果对乳腺癌患者在进行21基因检测复发风险评分后,将90例患者换分为低风险63例,中、高风险27例。TNM分期、临床分期、分子分型、Ki-67阳性指数、ER阳性指数与21基因检测之间具有较为明显的统计学意义(P<0.05)。在21基因检测前,初步确定37例患者适用于辅助内分泌治疗(HT)方案,其中低风险患者为34例,中高风险患者为3例。53例患者适用于辅助化疗+内分泌治疗(CHT)方案,其中低风险患者为29例,中高风险患者为24例,而在进行21及基因检测后,期辅助化疗决策发生了一定的转变,其中72例患者采用HT方案来进行治疗,其中35例患者从CHT方案更改为HT方案,低风险患者为26例,中高风险患者为9例。而行CHT方案的患者为18例,其中低风险患者为3例,中高风险患者为15例。在此期间无增加其他乳腺癌辅助化疗患者。在进行21基因检测前、后之间具有统计学差异(P<0.05)。结论对ER阳性早期乳腺癌患者采用21基因进行检测,其复发风险评分能够避免对不同风险患者术后过度辅助化疗以此减少患者自身化疗后的副作用。Objective To analyze the role of 21-gene detection in postoperative adjuvant chemotherapy for ER-positive early breast cancer.Methods Selected from April 2020 to April 2022,Ninety female patients who received breast cancer surgery in our hospital were selected.The patients were ER positive and lymph node neg ative in postoperative pathological examination,and immunohistochemical method was used to detect cell nuclei.Related antigen(Ki-67)and estrogen receptor(ER)expression;21 genes were detected by branched DNA-liquid phase chip technology.Results After performing the 21-gene detection recurrence risk score for breast cancer patients,90 patients were divided into 63 low-risk patients and 27 medium-and high-risk patients.There were significant differences between TNM staging,clinical staging,molecular typing,Ki-67 positive index,ER positive index and 21-gene detection(P<0.05).Before the 21-gene test,37 patients were preliminarily determined to be suitable for adjuvant endocrine therapy(HT)program,including 34 patients with low risk and 3 patients with medium and high risk.53 patients were suitable for adjuvant chemotherapy+endocrine therapy(CHT)program,of which 29 were low-risk patients and 24 were medium-high risk patients.Seventy-two patients were treated with the HT regimen,of which 35 patients were changed from the CHT regimen to the HT regimen,26 were low-risk patients,and 9 were intermediate-high risk patients.In contrast,18 patients underwent CHT,including 3 low-risk patients and 15 medium-high risk patients.There were no additional adjuvant chemotherapy patients for other breast cancer patients during this period.There was a statistical difference between before and after the 21-gene detection(P<0.05).Conclusion Using 21 genes to detect ER-positive early breast cancer patients,its recurrence risk score can significantly avoid excessive adjuvant chemotherapy after surgery for patients with different risks,thereby reducing the incidence of postoperative chemotherapy for these patients,thereby reducing the nu

关 键 词：21基因复发风险评分 雌激素受体阳性 早期乳腺癌 辅助化疗 

分 类 号：R737.9[医药卫生—肿瘤]