摘要
目的前瞻性研究分子分型及动态增强MRI对乳腺癌新辅助治疗疗效的预测和评价价值。方法选择2010年1月至2011年12月实施新辅助治疗并完成R0切除手术的79例乳腺癌患者，均为女性，年龄28—67岁，中位年龄48岁；其中LuminalA型6例，LuminalB型42例，HER．2阳性型14例，三阴型17例。研究入组患者动态增强MRI评价与病理疗效评价间的关系，分析分子分型及动态增强MRI对新辅助治疗疗效的预测和评价作用。结果新辅助治疗临床有效率为83．5％（66／79），病理有效率为79．7％（63／79）。79例患者中27例获得病理完全缓解（34．2％），其中LuminalB型12例（28．6％，12／42），HER-2阳性型5例（5／14），三阴型10例（10／17）。分子分型与病理完全缓解具有统计学相关性（P=0．039）。动态增强MRI临床疗效评价与病理疗效评价间有统计学相关性（r=0．432，P=0．000）。结论分子分型对乳腺癌新辅助治疗疗效具有预测价值，动态增强MRI检查与新辅助治疗后组织病理疗效评价具有相关性，有助于新辅助治疗疗效评价。
Objective To investigate the predictive value of molecular subtypes and the evaluational value of dynamic contrast-enhanced MRI of neoadjuvant chemotherapy for breast cancer. Methods From January 2010 to December 2011, the 79 patients diagnosed as primary invasive breast cancer, having received 6 cycles of neoadjuvant chemotherapy and finished the mastectomy or the breast conserving surgery entered this study. A total of 79 patients participated in this prospective study. There were 6 （7.6%） luminal A cases, 42 （53.2%） luminal B cases, 14 HER-2 （17.7%） positive cases and 17 （21.5%） triple negative cases. The associations between molecular subtypes and clinical response as well as the pathological response were analyzed. The predictive value of molecular subtypes for the neoadjuvant chemotherapy was studied. Results Clinical effective rate was 85.3% （66/79）. There was no statistical correlation between molecular subtypes and clinical effective rate. Pathologic effective rate was 79.7% （63/79）. There was no statistical correlation between molecular subtypes and pathologic effective rate. Twenty-seven case achieved pathologic complete remission （pCR） in all the patients. No case achieved pCR in the patients classified as Luminal A. Twelve cases （ 28. 6% , 12/42 ） achieved pCR in the luminal B Patients. Five cases （ 5/14 ） achieved pCR in the HER-2 overexpression patients. Ten cases （ 10/17 ） achieved pCR in the triple-negative patients. There was a statistical correlation between the molecular subtypes and the pCR rate （P = 0. 039 ）, and between clinical evaluation by dynamic contrast-enhanced MRI and evaluation of pathological response （ r = 0. 432, P = 0. 000 ）. Conclusions Molecular subtypes and dynamic contrast-enhanced MRI have a good value of predicting and evaluating the response of neoadjuvant chemotherapy on breast cancer.
出处
《中华外科杂志》
CAS
CSCD
北大核心
2013年第8期706-709,共4页
Chinese Journal of Surgery
基金
北京市科委科技计划资助项目（D090507043409010）
首都医学发展科研基金资助项目（2009-1011）
关键词
乳腺肿瘤
肿瘤辅助疗法
治疗结果
磁共振成像
Breast neoplasms
Neoadjuvant therapy
Treatment outcome
Magnetic resonanceimaging
