乳腺癌激素受体、c-erbB-2表达与FEC方案新辅助化疗疗效的相关性

Correlation of Hormone Receptors, c-erbB-2 Expression and Response to FEC Neoadjuvant Chemotherapy in Breast Cancer

目的探讨乳腺癌雌孕激素受体、c-erbB-2表达与FEC方案新辅助化疗疗效之间的相关性。方法选择90例术前确诊为乳腺癌患者在接受新辅助化疗之前用免疫组织化学法检测乳腺癌组织中雌孕激素受体(ER、PR)和c-erbB-2的表达情况,新辅助化疗结束后进行疗效评价,分析它们之间的相关性。结果90例患者中,临床完全缓解(cCR)19例,部分缓解(PR)41例,无变化(NC)30例,总有效率为66.67%,其中病理完全缓解pCR12例(13.33%)。在受体双阴的42例患者中,32例有效(cCR+PR),有效率为76.19%;其中pCR9例(21.43%)。受体单阳或双阳的48例患者中,28例有效(cCR+PR),有效率为58.33%;其中pCR3例(6.25%)。受体双阴组患者的有效率与受体单阳或双阳组患者比较,未见显著性差异(P>0.05)。但受体双阴组患者的pCR率明显高于受体单阳或双阳组患者,差异具有显著性(P<0.05)。c-erbB-2阳性表达36例,22例有效(cCR+PR),有效率为61.11%;其中pCR4例(11.11%)。c-erbB-2阴性表达54例,38例有效(cCR+PR),有效率为70.37%;其中pCR8例(14.81%)。c-erbB-2表达与化疗疗效无明显相关(P>0.05)。结论受体双阴患者可能较受体单阳或双阳患者对FEC方案化疗的敏感性更高。尤其是受体双阴组患者的pCR率明显高于受体单阳或双阳组患者。

Objective To study the correlation between expression of estrogen receptor（ER）, expression of progesterone receptor （Pit）, expression of c--erbB--2 and the response to FEC neoadjuvant chemotherapy in breast cancer. Methods Choosing 90 patients with breast cancer before the operation were treated with neoadjuvant chemotherapy. ER, PR and c--erbB--2 were examined immunohistochemically before chemotherapy and the response was evaluated after it and the correlation between them was analysized. Results Among 90 patients with breast cancer, 19 patients achieved clinic complete release （cCR） and 9 pathology complete release（PCR）, 41 partial release（PR） and 30 no change （NC）. The overall response rate was 66.67% and the pCR rate was 13.33%. In 42 patients with ER and PR absent, 32 patients achieved clinic complete release and partial release（cCR＋PR）and 9 pathology complete release （pCR）.In 48 patients with ER or PR positive tumors, 28 patients achieved clinic complete release and partial release （cCR＋PR） and 3 pathology complete release（pCR）.Compared the response rates of the two groups （76.19% vs. 58.33%）, there was no statistical significance （P〉0.05）.But the pCR rate of the former one was obviously higher than the later one, with statistical significance （P〈0.05）. In 36 patients with c--erbB--2 positive expression,22 patients achieved clinic complete release and partial release （cCR＋FPR） and 4 pathology complete release（pCR）. The response rate was 61.11% and the pCR rate was 11. 11%. In 54 patients with c--erhB--2 negative expression, 38 patients achieved clinic complete release and partial release（eCR-FPR） and 8 pathology complete release （pCR）. The response rate was 70.37% and the pCR rate was 14.81%. There was no obvious correlation between c-erbB--2 expression and the response to neoadjuvant chemotherapy. Conclusion Breast cancer with ER and PR absent may be more sensitive to FEC neoadjuvant chemotherapy. Especially, the pCR rate of the patients with ER and PR absent was obviously higher than the patients with ER and PR positive tumors.