摘要
目的 旨在观察局部进展期乳腺癌新辅助化疗的临床病理学改变。方法 局部进展期乳腺癌4 0例术前用粗针穿刺获组织学检查证实为乳腺癌 ,并作免疫组化进行ER、PR、cerb -B2、p5 3、Ps2、nm2 3、CathD等项目检测 ,新辅助化疗采用TA化疗方案 ,3周为一个周期 ,完成 2～ 6周期不等进行临床评价疗效。对术后标本进行HE、免疫组织化学染色观察。结果 总有效率 (RR)为 90 0 % (36 / 4 0 ) ,13例 (32 5 % )临床完全缓解 (cCR) ,2 3例 (5 7 5 % )部分缓解 (PR) ,4例 (10 0 % )无变化 (NC) ,无进展病例。其中 9例(2 2 5 % )病理完全缓解 (pCR)。行保乳手术 10例 (10 / 4 0 )。与术前病理检验标本比较 ,乳腺癌化疗后出现瘤体缩小变软、甚至消失 ,肿瘤细胞退变坏死、间质水肿、玻璃样变性、血管周围炎症细胞浸润及纤维化等改变 ;相应病例腋窝淋巴结转移灶亦有上述改变 ,而且淋巴结无论有无转移均可见结构改变 ,淋巴细胞松散 ,正常滤泡结构消失 ,甚至于出现正常淋巴结不见的充血现象 ,有大量噬细胞反应。免疫组织化学未见P5 3、cerb -B2、CathD蛋白阳性表达变化 ,ER、PR表达无显著差异。结论 TA新辅助化疗对多数乳腺癌的原发灶及腋窝淋巴结转移灶均不同程度变性坏死 ,增加了保乳手术机会 ,同时在抑制乳腺癌微转?
Objective To investigate histopathological change of locally advanced breast cancer following neoadjuvant chemotherapy. Methods Samples were obtained from 40 patients with breast carcinoma who received neoadjuvant chemotherapy of epirubicin plus paclitaxel, histopathologic examination was carried out both pre-chemotherapy core biopsies and post-chemotherapy surgical specimens. Results The total response rate (RR) was 90.0% (36/40). A total of 32.5% (13/40) of the patients acquired clinical complete response (CR), 57.5% (23/40) partial response (PR), and 10.0% (4/40) no change (NC). Nine cases obtained pathologic complete response (pCR) and no progressive disease in all patients. Histopathologic changes, such as disintegration, necrosis, edema, fibrosis, hyaline degeneration, calcification were observed after neoadjuvant chemotherapy. The same changes were observed in the metastatic lymph nodes. The expression of P53, cerb-B2, CathD, and ER, PR didn't change significantly. Conclusions Neoadjuvant chemotherapy with TA regimens is effective to both primary tumors and axillary metastatic lymph nodes in breast cancer.
出处
《中国妇产科临床杂志》
2005年第1期44-47,共4页
Chinese Journal of Clinical Obstetrics and Gynecology
