原发性乳腺癌新辅助化疗疗效评价临床观察

The Clinical Observation of Evaluation of the Neoadjuvant Chemotherapeutic Effect on Primary Breast Cancer

目的:观察肿瘤残留病灶大小在原发性乳腺癌新辅助化疗疗效评价中的的意义。方法:将2000年11月～2006年3月408例于北京肿瘤医院乳腺中心就诊的原发性乳腺癌患者新辅助化疗后病理资料重新进行Miller&Payne(M&P)方法病理评价。将其超声影像结果与手术后M&P病理评价结果进行比较。结果:本组病例中临床有效且残留病灶<1cm 158例,达cCR者53例,cPR者105例。病理显效(M&p病理评价G4G5)117例(74%);最大径>1cm的239例中病理显效占76列(31.8%),二者之间的差别有统计学意义(Spss13.0,Pearson Chi-Square,卡方=60.939,P<0.001)。达cCR者53例,病理非显效(M&P 1～3级)者6例。结论:原发性乳腺癌新辅助化疗后残留肿瘤病灶≤1cm时,有良好的病理反应。

Objective：To observe the significance of the tumor residue after neoadjuvant chemotherapy in evaluating therapeutic effect on primary breast cancer.Methods：All the patients of the primary breast cancer were conducted neoadjuvant chemotherapy in the breast center of BJMU From nov.2000 to Mar 2006,and then all were reevaluated by Miller ＆ Payne（M＆P）methods,and the results were compared with that of the ultrasonographic evaluation.Results：In all the patients, 158 cases that the diameter of tumor residue was equal to or less than 1 cm under ultrasound after primary chemotherapy reached cPR,and among these cases 53 cases reached cCR, 105 reached cPR.And 117（74%）cases were pathologically excellence （M＆P pathologic evaluation,G4GS）;while in the other 239 cases that the diameter of tumor residue was more than l cm under ultrasound,only 76（31.8%）cases were pathologically excellence,there is statistically significant difference between them （Spss 13.0,Pearson Chi-Square,K=60.939,P〈0.001） o Conclusion：In primary breast cancer there may have better pathologic evaluation results when the diameter of the tumor residue is equal to or less than 1 cm under ultrasonograh after primary chemotherapy.