初治HER2阳性乳腺癌患者新辅助治疗后达tpCR的预测模型构建  

Predictive model construction of tpCR in newly treated HER2-positive breast cancer patients after neoadjuvant therapy

作　　者：邵佳 梅林[1] 夏明林 SHAO Jia;MEI Lin;XIA Minglin(Department of Oncology,Anqing Hospital,Anqing,Anhui 246000,P.R.China)

机构地区：[1]海军安庆医院肿瘤科,安徽安庆246000

出　　处：《中国普外基础与临床杂志》2024年第4期455-459,共5页Chinese Journal of Bases and Clinics In General Surgery

基　　金：安庆市医疗卫生类科技计划项目(项目编号:2020Z6005)

摘　　要：目的探讨初治人表皮生长因子受体2(human epidermal growth factor receptor 2,HER2)阳性乳腺癌患者新辅助治疗后达完全病理完全缓解(total pathological complete response,tpCR)的影响因素,旨在为手术方案制定及预后评估提供更多参考。方法回顾性纳入2021年1月至2023年1月于海军安庆医院接受新辅助治疗的95例初治HER2阳性乳腺癌患者的临床资料,采用多因素logistic回归模型探索初治HER2阳性乳腺癌患者新辅助治疗后达tpCR的影响因素。结果95例患者新辅助治疗后达tpCR 51例,未达tpCR 44例。多因素logistic回归模型分析结果显示,HER23+(OR=6.102,P=0.014)、分子分型为HER2+/激素受体–(HER2+/激素受体+OR=0.129,P=0.006)及采用曲妥珠单抗+帕妥珠单抗方案(OR=6.582,P=0.014)者的tpCR率更高,雌激素受体3+(OR=0.122,P=0.033)、孕激素受体3+(OR=0.179,P=0.020)、Ki-67指数为15%~30%(OR=0.088,P=0.030)和31%~60%(OR=0.066,P=0.017)者的tpCR率较低。该模型的预测曲线下面积为0.881[95%CI(0.815,0.947)]。结论初治HER2阳性乳腺癌患者新辅助治疗后达tpCR与免疫组织化学HER2表达水平、分子分型、新辅助靶向治疗方案等有关,同时基于这些影响因素构建的预测模型能够一定程度预测患者新辅助治疗后的tpCR效果。Objective To investigate the influencing factors of total pathological complete response(tpCR)in newly treated human epidermal growth factor receptor 2(HER2)-positive breast cancer patients after neoadjuvant targeted chemotherapy,so as to provide more reference for the formulation of surgical plan and prognosis assessment.Methods Ninety-five newly treated HER2-positive breast cancer patients after neoadjuvant targeted chemotherapy were retrospectively chosen in the period from January 2021 to January 2023 in our hospital and all patients were divided into tpCR group(51 cases)and non-tpCR group(44 cases)according to whether tpCR was achieved after neoadjuvant targeted chemotherapy or not.Univariate and multivariate methods were used to evaluate the independent influencing factors of tpCR after neoadjuvant targeted chemotherapy in newly treated HER2-positive breast cancer patients.The prediction model based on the above independent influencing factors was constructed and the potential predictive efficacy of this model for tpCR after neoadjuvant targeted chemotherapy was evaluated.Results Among 95 patients,51 patients achieved tpCR after neoadjuvant targeted chemotherapy and 44 patients did not achieve tpCR.The results of the multivariate logistic regression model analysis showed that the patients with HER23+(OR=6.102,P=0.014),HER2+/hormone receptor–(HER2+/hormone receptor+OR=0.129,P=0.006),and trastuzumab+pantomizumab treatment(OR=6.582,P=0.014)had higher tpCR rate,estrogen receptor 3+(OR=0.122,P=0.0.033),progesterone receptor 3+(OR=0.179,P=0.020),Ki-67 index of 15%–30%(OR=0.088,P=0.030)and 31%–60%(OR=0.066,P=0.017)had lower tpCR rate.The predicted area under the curve of this model was 0.881[95%CI(0.815,0.947)].Conclusions The achievement of tpCR after new adjuvant treatment in newly diagnosed HER2 positive breast cancer patients is related to the expression level of HER2 in immunohistochemistry,molecular typing and new adjuvant targeted treatment scheme.At the same time,the prediction model based on these i

关 键 词：乳腺癌 完全病理完全缓解 人表皮生长因子受体2 阳性表达 新辅助治疗 

分 类 号：R737.9[医药卫生—肿瘤]