新辅助化疗对乳腺癌骨髓微转移的影响

Effect of neo-adjuvant chemotherapy on bone marrow micrometastases of breast cancer

目的 研究乳腺癌骨髓微转移的临床特点及新辅助化疗对骨髓微转移的影响。方法 手术治疗的乳腺癌患者68例，采用ABC免疫组织化学染色法，用EMA、CK19单克隆抗体检测其骨髓微转移情况，分析其临床特点，并以骨髓微转移为指标，对比研究新辅助化疗的效果。结果 68例中，检出骨髓微转移21例，阳性率为30．9％。临床Ⅲ～Ⅳ期患者骨髓微转移率明显高于Ⅰ～Ⅱ期患者，而病理类型、年龄、绝经与否及淋巴结转移情况等与骨髓微转移未发现有明显相关性；接受新辅助化疗的患者，骨髓微转移阳性率明显低于未接受新辅助化疗者。结论 乳腺癌是一种全身性疾病，即使是在临床早期，也有相当比例的患者存在微转移，新辅助化疗可能通过抑制肿瘤的微转移在预防乳腺癌术后复发和转移上起重要作用。

Objective To investigate the clinical characteristic of bone marrow micrometastases in breast cancer and the effect of neo-adjuvant chemotherapy on it. Methods Bone marrow micrometastases were detected in 68 postoperative patients with breast cancer with ABC immunohistochemical technique. Among these patients,35 cases were given neo-adjuvant chemotherapy. Results Twenty one cases were detected to have micrometastases in bone marrow （30.9%）. The positive rate was significantly higher in stage Ⅲ-Ⅳ cases than that in stage Ⅰ-Ⅱ cases, but had no relationship with pathologic type,age,menopause and lymph node metastases. The patients treated with neo-adjuvant chemotherapy had significantly lower bone marrow micrometastases rate than those without neo-adjuvant chemotherapy. Conclusion There are considerable cases, even in the early stage of breast cancer, who had bone marrow micrometastases. Neo-adjuvant chemotherapy could reduce the bone marrow micrometastases,consequently reduce the recurrence and metastases after operation.