摘要
目的:探讨乳腺癌分子分型在新辅助化疗疗效及预后预测中的作用。方法:收集漯河市中心医院收治的236例接受新辅助化疗患者的临床病理资料,分为Luminal A、Luminal B、Her-2阳性和三阴乳腺癌4种分子分型,分析分子分型与临床病理因素、新辅助化疗疗效及5年生存率的相关性。结果:236例患者中,107例(45.3%)为Luminal A亚型,47例(19.9%)为Luminal B亚型,27例(11.4%)为Her-2阳性亚型,55例(23.3%)为三阴乳腺癌亚型。Her-2阳性(25.9%)及三阴乳腺癌亚型(30.9%)的病理完全缓解(pCR)率明显高于Luminal亚型(Luminal A亚型4.7%及Luminal B亚型8.5%),差异有统计学意义(P<0.05)。与Luminal亚型相比,Her-2阳性及三阴乳腺癌亚型具有更差的5年无病生存和总生存(P<0.01);获得pCR的乳腺癌患者的5年无病生存和总生存明显高于化疗后仍有癌残留的患者(P<0.05)。结论:相对于Luminal亚型,Her-2阳性和三阴乳腺癌亚型对新辅助化疗更为敏感,更易达到pCR;但是Her-2阳性和三阴乳腺癌亚型预后反而更差。
Objective：To investigate the predictive role of breast cancer molecular subtype in the response and outcome of breast cancer patients treated with neoadjuvant chemotherapy. Methods：We collected the data of 236 pa-tients with primary breast cancer treated with neoadjuvant chemotherapy in Luohe Central Hospital in this retrospec-tive study. The patients were classified into 4 subtypes：Luminal A,Luminal B,Her -2 positive and triple - negative.The correlation between molecular subtypes and clinic pathologic factors, efficacy of neoadjuvant chemotherapy and 5 -year survival were analyzed. Results：Among all 236 patients, 107（45. 3 % ） patients were Luminal A subtype,47 （19.9%） were Luminal B subtype ,27（ 11.4% ） were Her-2 positive subtype and 55（23. 3 % ） were triple - nega-tive subtype. The pCR rates of Her - 2 positive（25. 9 % ） and triple - negative（30. 9 % ） subtypes were higher than those of Luminal subtype（ Luminal A 4. 7% and Luminal B 8. 5 % ） ,with significant difference（P 〈0. 05）. Despite initial chemosensitivity, the patients with Her - 2 positive and triple - negative subtypes had worse 5 - year disease -free survival（ DFS） and 5 - year overall survival（ OS） （P 〈 0. 01） than those with Luminal subtypes in the whole pop-ulation. The 5 - year DFS and OS of patients who achieved pathological complete response（ pCR） were significantly higher than those of patients with residual disease after chemotherapy （ P 〈0. 05）. Conclusion ： Breast cancer patients with Her - 2 positive and triple - negative subtypes have higher sensitivity to neoadjuvant chemotherapy and with higher rates of pCR but worse prognosis than those with Luminal subtypes.free survival（ DFS） and 5 - year overall survival（ OS） （P 〈 0. 01） than those with Luminal subtypes in the whole pop-ulation. The 5 - year DFS and OS of patients who achieved pathological complete response（ pCR） were sig
出处
《现代肿瘤医学》
CAS
2017年第10期1564-1568,共5页
Journal of Modern Oncology
关键词
乳腺癌
分子分型
新辅助化疗
预后
breast cancer,molecular subtypes,neoadjuvant chemotherapy,prognosis
