乳腺癌新辅助化疗前检测雌激素受体和孕激素受体的临床意义

Expression and significance of ER and PR in neoadjuvant chemotherapy of breast cancer

目的探讨新辅助化疗对乳腺癌组织中雌激素受体（ER）和孕激素受体（PR）表达的影响以及新辅助化疗前后测定ER、PR的必要性。方法2000年1月至2008年1月对231例Ⅱ～Ⅲ期局部晚期乳腺癌进行CMF、CAF或CTF、AT等不同方案进行新辅助化疗，在化疗前后分别进行ER和PR的检测，以了解新辅助化疗前后ER和PR的变化。结果ER新辅助化疗前阳性表达率为44．39％，新辅助化疗后的阳性表达率为63．23％，其差异有统计学意义（X^2=9．824，P〈0．05）。PR新辅助化疗前阳性表达率为60．99％，新辅助化疗后的阳性表达率为60．09％，其差异无统计学意义（X^2=3．526，P〉0．05）。结论由于新辅助化疗对部分ER、PR的表达有影响，且与化疗疗效有关，所以必须在对所有实施新辅助化疗的乳腺癌患者实施化疗前后ER、PR的测定，为以后的综合治疗提供必要的依据。同时认为TA方案优于CAF或CTF方案，CAF或CTF方案又优于CMF方案。

Objective To investigate the expression of ER and PR after undergoing neoadjuvant chemotherapy and significance. Methods To retrospectively analyze the clinical data of 231 stage Ⅱ - Ⅲ locally advanced breast cancer from 2000 to 2008, who have conducted the neoadjuvant chemotherapy of CMF, CAF, CTF and AT. The change of ER and PR were examined after neoadjuvant chemotherapy. Results The positive percentiage of ER expression was 44.39% before neoadjuvant chemotherapy, the ER expression was 63.23% after chemotherapy. The difference was statistically significant （X^2 = 9. 824, P 〈 0.05）. The percentiage of PR expression were 60.99% and 60.09% （X^2 = 3. 526, P 〉 0. 05）. Conclusions It is necessary to examine the expression of ER and PR for breast cancer pationts who undergoing neoadjuvant chemotherapy. TA regimen is better than CAF or CTF. CAF and CTF regimens were better than CMF.