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

目的探讨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100例,采用免疫组化SP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,评价新辅助化疗对阳性患者的影响。结果100例中,检出骨髓微转移31例,阳性率为31.0%。临床Ⅲ期患者骨髓微转移率明显高于Ⅰ～Ⅱ期患者,阳性患者接受新辅助化疗后,转阴率达67.7%。结论乳腺癌是1种全身性疾病,即使在临床早期也有相当比例微转移,新辅助化疗对抑制骨髓微转移有效,可以指导化疗方案的选择,并可能对预防术后复发和转移起重要作用。

Objective To explore 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 before and after neo-adjuvant chemotherapy in 100 patients with breast cancer by SP-immunohistochemical technique,using EMA,CK19 monoclonal antibody.The clinical features were analysed and bone marrow micrometastases-positive patients were given neo-adjuvant chemotherapy.The effect of neo-adjuvant chemotherapy was evaluated.Results 31 patients had micrometastases in bone marrow before treatment,and the positive rate was 31%.The positive rate was significantly higher in stageⅢ cases than in stage Ⅰ～Ⅱcases.Of the 31 patients with positive micrometastases,67.7% had negative micrometastases in bone morrow after neo-adjuvant chemotherapy.Conclusion Breast cancer is a systemic disease,and could have micrometastases in bone morrow even in patients with early disease.Neo-adjuvant chemotherapy could effectively control the micrometastases.