不同新辅助化疗周期对于HER2阴性乳腺癌的临床应用研究

Clinical Application of Basic Research on Neoadjuvant Chemotherapy for Her2-negative Breast Cancer

目的:对比分析HER2阴性乳腺癌4、6周期(1个周期就是1个疗程,时间为21 d)新辅助化疗疗效,以及相关分子标志物:ER、PR、Ki-67的表达水平对HER2阴性乳腺癌化疗效果的影响。方法:随机选择深圳市二人民医院在2014年10月至2015年10月收治的HER2阴性乳腺癌患者100例。其中50例实施4周期的新辅助化疗的治疗,另50例实施6周期的新辅助化疗。使用统计学分析的方法对比分析乳腺癌患者在实施4周期以及6周期后的新辅助化疗的治疗效果。另需要对比两组患者相关分子标志物:ER、PR、Ki-67的表达变化水平对HER2阴性乳腺癌化疗疗效的影响。结果:(1)4周期组和6周期组新辅助化疗的总有效率无差异。(2)在新辅助化疗后的ER或PR方面,阴性患者4周期和6周期的治疗有效率差异无统计学意义(P>0.05);阳性4周期和6周期有效率无差异。(3)在Ki-67的表达方面,Ki-67阴性患者4周期和6周期有效率无差异。Ki-67阳性患者,4周期治疗有效率为92%,6周期有效率为57%,差异具有统计学意义(P<0.05)。结论:(1)HER2阴性乳腺癌患者,4周期或6周期新辅助化疗,均能够取得较好的临床治疗效果。(2)在新辅助化疗后的ER或PR方面,无论是阴性还是阳性表达患者,在经过4周期或6周期的新辅助化疗后,其临床治疗效果并无显著差异。(3)在Ki-67表达方面,阳性患者的治疗效果明显高于阴性患者。

Objective To compare and analyze the evaluation of efficacy of neoadjuvant chemotherapy for HER2 negative breast cancer during four and six cycle（1 cycle was a treating period with 21 d）,and its related molecular markers of the infl uence of the expression level of ER,PR,and Ki-67 in the treatment of HER2 negative breast cancer chemotherapy.Methods Random selection of 100 patients,and HER2 negative breast cancerand who accepted treatments in October 2014 to October 2015 of shenzhen second people＇s hospital。50 patients were required to be implemented the treatment of four cycles of neoadjuvant chemotherapy;And the other 50 patients were required to be implemented the treatment of six cycles of neoadjuvant chemotherapy.Then,the methods of statistical analysis,and the treatment effect of neoadjuvant chemotherapy of Patients with breast cancer after the implementation for the 4 cycle and 6 cycles were compared and analyzed.In addition,the related molecular markers of two groups of patients were needed to be compared,including the infl uence of the expression level of ER,PR,and Ki-67 in the treatment of HER2 negative breast cancer chemotherapy.Results 1.The 4 cycle group and the 6 cycle group neoadjuvant chemotherapy of total effective rate was no difference.2.In the ER or PR aspects after neoadjuvant chemotherapy,The effective rates of 4 cycles and 6 cycles of negative patients were not statistically significant（P0.05）,and no significant differences in the effective rates of positive 4 cycles and 6 cycles.3.In terms of Ki-67 expression,Ki-67 negative patient of no significant differences in the effective rates.The effective rate was 92 % in Ki-67 positive patients for 4 cycles,while effective rate was 57 % for 6 cycles,there are statistical significance（P0.05）.Conclusion1.For patients with HER2 negative breast cancer,4 cycles or 6 cycles,which can achieve better clinical treatment effect.2.In the ER aspects or PR aspects after neoadjuvant chemotherapy,whether the negative or positive expression patients,after 4 cycles or 6 cycles of neoadjuvant chemotherapy,there are no significant difference in the clinical treatment.3.the treatment effect of Ki-67,positive patients are significantly higher than that of Ki-67 negative patients.