摘要
目的：探讨新辅助化疗对乳腺癌雌激素受体（ER）、孕激素受体（PR）表达的影响及ER、PR的变化与新辅助化疗临床疗效的相关性,从而明确新辅助化疗后ER、PR表达改变的临床意义。方法：选取2007年至2009年经空心针穿刺病理诊断明确的乳腺癌患者63例予以新辅助化疗,通过免疫组织化学法分别检测化疗前后乳腺癌组织中ER、PR的表达。化疗方案（TThpC方案）：多西紫杉醇（艾素）70 mg.m-2,d1;吡柔比星60 mg,d1;环磷酰胺500 mg.m-2;21 d为1个周期。经过3~4个周期的新辅助化疗,评估化疗疗效,再行乳腺癌改良根治手术或保乳术,比较化疗前后ER、PR表达的变化,分析ER、PR表达的变化与化疗疗效的相关性。结果：63例乳腺癌新辅助化疗病例中,由ER、PR（＋）变为ER、PR（-）6例（A组）,由ER、PR（-）变为ER、PR（＋）8例（B组）,ER、PR仍为阳性37例（C组）,ER、PR仍为阴性12例（D组）,新辅助化疗前后ER、PR的表达差异有统计学意义（P〈0.001）,ER（-）与ER（＋）患者疗效比较差异无统计学意义（P=0.338）。4个亚组间疗效差异无统计学意义（P=0.491）。结论：新辅助化疗能够改变ER和（或）PR表达状态,但是新辅助化疗疗效与乳腺癌患者的ER和（或）PR表达状态无明显相关性,同时新辅助化疗前后ER和（或）PR的改变与疗效亦无明显相关性。
Objective： To study influence of NAC on the expression of ER and PR in patients with breast cancer and its correlation with clinical curative effects.Methods： From 2007 to 2009 the ER and PR expression before and after NAC of 63 patients with breast cancer were detected by immunohistochemistry.The neo-adjuvant chemotherapy regimen（TThpC regimen） was taxotere 70 mg·m-2 in day one,pirarubicin 60 mg in day one,cyclophosphamide 500 mg·m-2 in day one.Twenty-one days was one cycle.After 3-4 cycles,the patients were underwent surgical operation.The changes of ER and PR expression before and after NAC were compared and its correlation with NAC′s clinical curative effects was analyzed.Results： Among the 63 patients,6 cases（group A）showed a transformation of the expression of ER and PR from positive to negative,8 cases（group B）showed a transformation of the expression of ER and PR from negative to positive,37 cases（group C） kept the expression of ER and PR positive,12 cases（group D） kept the expression of ER and PR negative,with statistical alteration for ER and PR status due to NAC（P0.001）,and non-statistical diversity for therapeutic effects between ER negative and positive patients（P=0.338） and between the four groups（P=0.491）.Conclusion： NAC can chang the ER and PR expression status in patients with breast cancer,but there is no statistically related to clinical performance of NAC,and there is no relationsipe between the ER,PR expression status and NAC neither.
出处
《现代医学》
2010年第5期495-498,共4页
Modern Medical Journal
关键词
乳腺癌
新辅助化疗
雌激素受体
孕激素受体
breast cancer
neo-adjuvant chemotherapy
estrogen receptor
progesterone receptor
