乳腺癌新辅助化疗疗效与分子分型的研究

Research on relationship between curative effect of breast cancer neoadjuvant chemotherapy and molecular subtypes

目的探讨乳腺癌分子分型与多西他赛联合表柔比星和环磷酰胺(TAC方案)新辅助化疗疗效的关系。方法选择2006年1月至2013年12月接受TAC方案进行新辅助化疗的105例乳腺癌患者进行回顾性研究,根据免疫组织化学测定的雌激素受体(ER)、孕激素受体(PR)、人表皮生长因子受体2(HER-2)及Ki-67将乳腺癌分为Luminal A、Luminal B、HER-2阳性和Basal-Like 4个亚型,分析不同亚型疗效的差别。结果 105例患者中,19例(18.1%)患者为Luminal A亚型,45例(42.9%)患者为Luminal B亚型,28例(26.7%)例为HER-2阳性亚型,13例(12.4%)例为Basal-Like亚型。Luminal B亚型及Basal-Like亚型完全缓解率分别为1.9%、1.0%,与Luminal A型及HER-2阳性型比较,差异无统计学意义(P=0.409 6)。化疗周期是新辅助化疗获得病理完全缓解(pCR)的独立预测因子。化疗周期越长的患者,pCR率越高[OR=1.645,95%CI(1.105,2.450),P=0.014]。结论乳腺癌分子亚型不能预测新辅助化疗的疗效,而化疗周期是新辅助化疗获得pCR的独立预测因子。

Objective To investigate the relationship between the molecular subtypes of breast cancer and neoadjuvant chemotherapy with TAC（docetaxel,epirubicin and cyclophosphamide）.Methods One hundred and five patients treated with neoadjuvant chemotherapy were included in this retrospective study.Molecular subtypes were constructed from immunohistochemical results of estrogen receptor（ER）,progesterone receptor（PR）,HER-2status and Ki-67,which were classified as Luminal A,Luminal B,HER-2positive and Basal-Like subtype.Results Of a total of 105 patients,19cases（18.1%）of Luminal A were found;45cases（42.9%）of Luminal B were found,28cases（26.7%）of HER-2were found,13case（12.4%）of Basal-Like was found;the pCR rate of Luminal B was 1.9%,the pCR rate of Basal-Like was 1.0%.The differences of four molecular subtypes weren′t statistically significant（P =0.409 6）.The cycles of neoadjuvant chemotherapy can predict the response of breast cancer.Conclusion Molecular subtypes can′t predict the curative effect of breast cancer neoadjuvant chemotherapy.The cycles of neoadjuvant chemotherapy can predict the response of breast cance.