乳腺癌新辅助治疗Neo-Bioscore评价体系与无病生存的相关性

A study on the correlation between Neo-Bioscoresystem and disease-free survival of breast cancer patients with neoadjuvant chemotherapy

目的 探究我国乳腺癌患者新辅助治疗后Neo-Bioscore得分与其无病生存期（DFS）的相关性.方法 分析2005年1月1日-2015年12月31日在解放军第三○七医院接受新辅助治疗的429例早期或局部晚期乳腺癌患者的临床病理资料,并随访其DFS.结果 Neo-Bioscore得分与DFS密切相关（χ2=47.662, P〈0.001）.当以3分为界值进行疾病复发风险分组时,与DFS的相关性更强（HR=5.093 与HR=2.044）,并对绝经前激素受体（HR）阳性患者辅助内分泌方案的选择,具有等效于传统复发风险分组的作用,且在HR阳性/人表皮生长因子受体2（ HER-2）阴性（P〈0.001 与P=0.166）、HER-2阳性（P〈0.001与P=0.068）、HR阴性/HER-2阴性（P=0.013 与P=0.208）等相同分子病理亚组中,比以是否病理完全缓解（pCR）分组具有更好的DFS相关性.结论 乳腺癌患者新辅助治疗后,其Neo-Bioscore得分可作为预测DFS的早期指标;当以3分为界值进行复发风险分组时,与DFS的相关性更强,并可用于指导绝经前HR阳性患者辅助内分泌方案的选择.

Obiective To explorethe correlation between Neo-Bioscore and disease-free survival （DFS） after neoadjuvant therapy in patients with breast cancer in China. Methods The clinical and pathological data of 429 patients with early or locally advanced breast cancer who received neoadjuvant therapy at the No.307 Hospital of PLA from January 1, 2005 to December 31, 2015 were analyzed and we followed up their DFS. Results Neo-Bioscore were closely related to DFS （χ2=47.662, P〈0.001）. When the groups were divided by Neo-Bioscore 3, they weremore relevantto DFS （HR=5.093 vs HR=2.044）, equivalent to the role of traditional recurrence risk grouping in guiding the choice of adjuvantendocrine regimen for hormone receptor （HR） positive patients who were premenopausalafter neoadjuvant chemotherapy, andmore relevantto DFS than whetherthe pathologic complete response （Pcr）grouping in the same molecular pathology subgroup of HR positive/human epidermal growth factor receptor 2 （HER-2）negative （P〈0.001 vs P=0.166）, HER-2 positive （P〈0.001 vs P=0.166）, Hrnega