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中华临床医师杂志(电子版) ›› 2021, Vol. 15 ›› Issue (10) : 754 -759. doi: 10.3877/cma.j.issn.1674-0785.2021.10.007

所属专题: 乳腺疾病

乳腺癌·临床研究

不同类型乳腺癌新辅助化疗疗效评价及预后影响因素分析
郭俏丽1, 宋庆志2, 胡慧3,()   
  1. 1. 518036 深圳,北京大学深圳医院乳腺甲状腺外科;515041 汕头,汕头大学医学院
    2. 518036 深圳,北京大学深圳医院乳腺甲状腺外科;230000 合肥,安徽医科大学
    3. 518036 深圳,北京大学深圳医院乳腺甲状腺外科
  • 收稿日期:2021-08-31 出版日期:2021-10-15
  • 通信作者: 胡慧
  • 基金资助:
    深圳市医学重点学科建设(SZXK017); 广东省深圳市三名工程项目(SZSM201612010)

Effiacy of neoadjuvant chemotherapy for different subtypes of breast cancer and factors influencing prognosis

Qiaoli Guo1, Qingzhi Song2, Hui Hu3,()   

  1. 1. Department of Breast and Thyroid Surgery, Peking University Shenzhen Hospital, Shenzhen 518036, China; Shantou University Medical College, Shantou 515041, China
    2. Department of Breast and Thyroid Surgery, Peking University Shenzhen Hospital, Shenzhen 518036, China; Anhui Medical University, Hefei 230000, China
    3. Department of Breast and Thyroid Surgery, Peking University Shenzhen Hospital, Shenzhen 518036, China
  • Received:2021-08-31 Published:2021-10-15
  • Corresponding author: Hui Hu
引用本文:

郭俏丽, 宋庆志, 胡慧. 不同类型乳腺癌新辅助化疗疗效评价及预后影响因素分析[J/OL]. 中华临床医师杂志(电子版), 2021, 15(10): 754-759.

Qiaoli Guo, Qingzhi Song, Hui Hu. Effiacy of neoadjuvant chemotherapy for different subtypes of breast cancer and factors influencing prognosis[J/OL]. Chinese Journal of Clinicians(Electronic Edition), 2021, 15(10): 754-759.

目的

探讨不同分子分型乳腺癌新辅助化疗疗效及影响患者预后的因素。

方法

回顾性收集2015年11月至2018年12月就诊于北京大学深圳医院乳腺外科接受新辅助化疗的95例患者的临床病理资料及新辅助化疗后的术后病理完全缓解(pCR)率,2021年1月进行随访,分析影响患者pCR及预后的因素。

结果

95例患者中,新辅助化疗后达到完全缓解共18例,pCR率为18.9%。不同分子分型pCR分布不同,差异有统计学意义(P<0.05)。单因素分析发现pCR与患者雌激素受体(ER)/孕激素受体(PR)状态及分子分型相关(P<0.05);多因素分析则显示在排除其他因素的影响下,Luminal B型人类表皮生长因子受体2(HER2)阴性型相比于三阴型患者新辅助化疗后pCR率低(P<0.05)。不同分型患者在新辅助治疗后无病生存期差异无统计学意义(P>0.05)。

结论

不同分子分型乳腺癌新辅助化疗的pCR有差异,是否行新辅助化疗需综合考虑患者的临床病理特征及分子分型等决定。

Objective

To explore the curative effect of neoadjuvant chemotherapy for different subtype of breast cancer and the influencing factors of prognosis.

Methods

The clinicopathologic data and pathological complete response (pCR) rate in 95 patients with breast cancer after neoadjuvant chemotherapy at Peking University Shenzhen Hospital were retrospectively collected and analyzed. Follow-up was conducted in January 2021 to analyze the factors affecting pCR and prognosis.

Results

Among the 95 patients, 18 (18.9%) had a pCR after neoadjuvant chemotherapy. The distribution of pathological response across four subtypes was significantly different (P<0.05). Univariate analysis showed that the expression of estrogen receptor/progesterone receptor and the subtype of breast cancer were correlated with pCR (P<0.05). Multivariate analysis showed that the pCR rate in Luminal B human epidermal growth factor receptor 2(HER2) negative breast cancer was lower than that in triple negative breast cancer (P<0.05). There was no difference in disease free survival among different subtypes of breast cancer (P>0.05).

Conclusion

The selection of neoadjuvant chemotherapy should consider clinicopathological characteristics and the subtype of breast cancer.

表1 不同分子分型的乳腺癌患者术后Miller-Payne分级比较(例)
表2 乳腺癌患者新辅助化疗后病理完全缓解影响因素的单因素分析(例)
表3 乳腺癌患者新辅助化疗后病理完全缓解影响因素的多因素分析
图1 新辅助化疗后不同分子分型乳腺癌患者无病生存情况注:HER2为人表皮生长因子受体2
图2 新辅助化疗后不同Miller-Payne分级乳腺癌患者无病生存情况
表4 乳腺癌患者新辅助化疗后无病生存期的影响因素分析
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