230例乳腺癌新辅助化疗患者pCR的影响因素分析

Analysis of Influence Factors of Pathological Complete Remission in 230 Cases of Breast Cancer Patients with Neoadjuvant Chemotherapy

目的探讨乳腺癌患者新辅助化疗后获得病理完全缓解(pCR)的影响因素。方法收集230例新辅助化疗的Ⅱ、Ⅲ期乳腺癌患者的临床及病理资料,对新辅助化疗后手术标本进行病理检测并评价化疗疗效,分析影响pCR的相关因素。结果 230例乳腺癌患者中,术后病理评估获得pCR的患者37例(16.1%),非p CR的患者193例(83.9%);单因素分析表明:淋巴结是否转移、激素受体表达、临床T分期及化疗周期数为影响乳腺癌新辅助化疗患者获得pCR的影响因素(P<0.05);多因素分析表明:雌激素受体(ER)表达、临床T分期及化疗周期数是乳腺癌pCR的独立影响因素。结论 ER表达阴性、临床分期T1～2期及化疗周期数>4的Ⅱ、Ⅲ期乳腺癌患者在新辅助化疗后具有更高的pCR率。

Objective To investigate the influencing elements of pathological complete remission(pCR)after neoadjuvant chemotherapy in breast cancer patients.Methods The clinical and pathological data of 230 patients with stageⅡorⅢbreast cancer underwent neoadjuvant chemotherapy were collected.Pathological evaluation was performed on surgical specimens after chemotherapy to assess the efficacy.Factors affecting the pCR were analyzed using univariate and multivariate logistic regression.Results Among the 230 patients with breast cancer,37 patients(16.1%)had pCR after pathological evaluation and 193 patients(83.9%)had non-pCR.Univariate analysis showed that lymph node metastasis,hormone receptor positive expression,clinical T stage and cycles of chemotherapy were the factors affecting pCR(P<0.05).Multivariate analysis showed that ER expression,clinical T stage and cycles of chemotherapy were independent factors of complete pathological remission in patients with breast cancer undergoing neoadjuvant chemotherapy(P<0.05).Conclusion Patients with breast cancer of stageⅡandⅢwhose ER expression is negative,clinical stage T1-2 and number of chemotherapy cycles >4 have higher pCR rate after neoadjuvant chemotherapy.