乳腺癌术前化疗疗效及其对分子标记物的影响

Effect of Pre-operative Chemotherapy and Its Influence on Molecular Markers in Breast Cancer

[目的]通过研究乳腺癌术前化疗疗效及其对分子标记物的影响,进一步评价新辅助化疗的临床价值。[方法]对100例经空芯针穿刺取材病理确诊的乳腺癌患者,给予术前化疗(新辅助化疗)方案2周期,继之行根治术,术后免疫组化测分子标记物ER、PR和c-erbB-2,并与化疗前的检查结果比对。[结果]经新辅助化疗后,乳腺癌原发灶明显缩小,11%(11例)达到完全缓解(CR);腋窝淋巴结阳性率下降,21.6%(8/37)达到完全缓解(CR);ER、PR和c-erbB-2的表达与新辅助化疗前不相符,不符合率分别为46%、37%和12%。[结论]新辅助化疗对降低病期、争取保乳机会、筛选敏感的化疗药物大有益处,但因其影响了术后ER、PR和c-erbB-2等分子标记物结果,不利于医生制定放疗、内分泌治疗及基因治疗等方案,有待于进一步研究解决此矛盾。

[Purpose]To investigate the response of neoadjuvant chemotherapy for breast cancer, and its influence on molecular markers.[Methods]One hundred breast cancer patients pathologically proved, received radical operation after 2 cycles of neoadjuvant chemotherapy.Immunohistochemical results of ER, PR and c- erbB-2 before chemotherapy and after operation were compared. [Results] After neoadjuvant chemotherapy, the primary cancer reduced significantly with 11% of complete response （CR）. The rate of positive axillary lymph node decreased with 21.6% of CR. Expression of ER（46%）, PR（37%）and c-erbB-2（12%） after operation were quite discrepancy with those before therapy. [Conclusion] Neoadjuvant chemotherapy may be beneficial to decrease the clinical stage, to get chance for breast conservation operation and to select sensitive agents for breast cancer, but it also influence on post-operation molecular markers, and interfere with treatment plan making.