分子分型和TOPOⅡα对乳腺癌新辅助化疗疗效及预后的预测

Prediction of Efficacy and Prognosis with Molecular Subtype and TOPOⅡα in Patients Undergoing Neoadjuvant Chemotherapy for Breast Cancer

目的探讨分子分型和TOPOⅡα的表达对乳腺癌新辅助化疗(NAC)疗效及预后的预测价值。方法对53例乳腺癌NAC患者进行回顾性分析,依据ER、PR、Her-2及Ki-67的表达进行分子分型,同时检测TOPOⅡα的水平(分为高表达和低表达)。分析各分子分型、TOPOⅡα与疗效及预后的关系。结果乳腺癌NAC总有效率为79.25%(42/53)。三阴性型、Luminal A型、Luminal B型和Her-2型4组分子分型间的疗效比较差异有统计学意义(P<0.05);三阴性型疗效优于Luminal A型(P<0.05),Luminal A型、Luminal B型、Her-2型三者间的疗效比较差异无统计学意义(P>0.05)。达到病理完全缓解(pCR)5例,三阴性型4例,三阴性型优于Luminal亚型(P<0.05)。OPOⅡα高表达者疗效优于低表达者(P<0.05)。在术后无病生存率方面,Luminal A型优于其他3个亚型,而三阴性型无病生存时间最差,低于其他3个亚型(P<0.05)。TOPOⅡα低表达者无病生存率优于高表达者(P<0.05)。结论分子分型和TOPOⅡα与乳腺癌NAC疗效及预后相关,三阴性型疗效较好,但预后较差,Luminal A型预后最好。TOPOⅡα低表达者疗效差,但预后较好。

Objective To study the values of molecular subtype and TOPO H a expression in predicting the efficacy and prognosis in patients undergoing neoadjuvant chemotherapy (NAC) for breast cancer. Methods Data of 53 patients who underwent NAC for breast cancer were analyzed retrospectively. According to the expression of ER, PR, Her-2 and Ki-67, these patients were divided into four molecular subtypes. According to TOPOH a levels,these patients were divided into high expression group and low expression group. The relationships of molecular subtypes and TOPO Ha levels to the efficacy and prognosis were analyzed. Results The overall response rate was 79. 25% (42/53). Compared with Luminal A subtype, the efficacy of NAC was significantly improved in basal-like subtype(P<C〇. 05). There were no significant differences in the efficacy among Luminal A subtype,Luminal B subtype and Her-2 subtype(P> 0. 05). Basal-like subtype(4 cases) was superior to Luminal sub type(l case) for achieving a pCR(P<C〇. 05). The efficacy of NAC in high TOPO II a expression group was better than that in low TOPO II a expression group (P<C〇. 05). The postoperative disease-free survival rate in Luminal A subtype was higher than that in other three subtypes(P<C〇. 05). Basal-like subtype exhibited the shortest disease-free survival(P<C〇. 05). The disease-free survival rate in low TOPOH a expression group was higher than that in high TOPOH a expression group(P<C0. 05). Conclusion Molecular subtype and TOPOH a are correlated with the efficacy and prognosis in patients undergoing NAC for breast cancer.Basal-like subtype is associated a good efficacy,but a poor prognosis. The prognosis is the best in Luminal A subtype. Patients with low TOPOH a expression have a good prognosis, but a poor efficacy.