乳腺癌新辅助化疗疗效评价方法的相关研究

Study on efficacy evaluation of neoadjuvant chemotherapy for breast cancer

目的探讨乳腺癌术前临床结合病理评价新辅助化疗的效果。方法 52例患者接受2个周期多西他赛、表柔比星、环磷酰胺(TAC)方案化疗,然后行乳房超声波检查的临床评价,临床评价无效的病例在超声波引导下行空芯针穿刺乳房病灶获取病理组织行病理评价,分析全部患者临床评价与术前临床结合病理评价的差异。全部病例继续TAC新辅助化疗2周期后行临床评价,全部病例行改良根治术,术后获得病理组织行病理评价。新辅助化疗4个周期后,分析全部患者临床评价与术后病理评价之间的差异。结果 2个周期新辅助化疗后,临床评价有效29例,术前临床结合病理评价40例,临床结合病理评价的效果与临床评价的效果比较两者之间差异有统计学意义(P<0.05);全部患者经4个周期新辅助化疗后,病理完全缓解与临床完全缓解的一致率为62.8%。结论术前临床结合病理评价能更能准确反映新辅助化疗的效果,有可能作为选择新辅助化疗方案的依据之一。

Objective To explore the clinical-pathologic evaluation of the efficacy of neoadjuvant chemotherapy for breast cancer before operation. Methods All 52 patients received two cycles of docetaxel,epirubicin and cyclophosphamide（ TAC） chemotherapy.The efficacy of neoadjuvant chemotherapy was clinically assessed using ultrasound examination. Then the patients with stable disease（ SD） underwent ultrasound-guided core needle biopsy to evaluate the pathological changes. The efficacy between clinical evaluation before surgery and clinical-pathological evaluation system was compared. After another two cycles of TAC chemotherapy,all patients were clinically evaluated,and the pathological changes after modified radical mastectomy of breast cancer were evaluated after surgery.The efficacy between clinical evaluation after surgery and pathological evaluation system was compared. Results After two cycles chemotherapy,29 cases were effective by clinical evaluation,and 40 cases were effective by clinical-pathological evaluation. The efficacy was statistically different between two evaluation methods（ P 〈0. 05）. After four cycles chemotherapy,the agreement rate between complete pathological response and complete clinical response was 62. 8%. Conclusion The clinical-pathological evaluation may more accurately reflect the efficacy of neoadjuvant chemotherapy,and it may be used as a basis for the selection of neoadjuvant chemotherapy plans.