乳腺癌新辅助化疗疗效的影响因素研究

Study of factors influencing therapeutic efficacy of neoadjuvant chemotherapy for breast cancer

目的分析乳腺癌新辅助化疗(NAC)疗效的影响因素。方法将2015年10月~2018年10月在我院行新辅助化疗的所有乳腺癌患者划分成若干个组,后以组为单位从中随机抽取85例患者为此次研究对象,均于NAC后开展手术治疗,所有患者均进行1年随访,同时均完成随访,依据疗效将85例患者分成完全缓解(CR)、部分缓解(PR)、稳定(SD)及进展(PD)共四组,比较四组患者临床资料差异情况,将有差异项带入Logistic回归方程,分析影响乳腺癌NAC疗效的主要因素。结果85例患者完成随访,其中CR共8例,PR共49例,SD共24例,PD共4例。三阴性型乳腺癌患者病理完全缓解(PCR)率高于LuminalA型、LuminalB型及Her-2过表达型患者,差异有统计学意义(P<0.05)。将有差异资料带入Logistic回归方程计算,发现肿瘤大小、BMI、化疗方案、化疗周期、p53表达以及乳腺癌分子分型均是影响乳腺癌NAC疗效的主要因素。结论影响乳腺癌NAC疗效的因素较多,主要和肿瘤大小、BMI、化疗方案、化疗周期、p53表达以及分子分型有关,同时肿瘤直径≤5cm、采取紫杉醇结合蒽环类化疗方案、化疗周期在4~6个周期、p53阴性以及乳腺癌分子分型为三阴性型的患者疗效优于其他患者。

Objective To analyze factors influencing therapeutic efficacy of neoadjuvant chemotherapy(NAC)for breast cancer.Methods All breast cancer patients who received neoadjuvant chemotherapy in our hospital from October 2015 to October 2018 were divided into several groups.Then 85 patients were randomly selected from the groups as the research object.All the 85 patients underwent surgical treatment after NAC.They were all followed up for 1 year and they all completed the follow-up.According to the therapeutic efficacy,the 85 patients were divided into four groups:Complete response(CR),partial response(PR),stable disease(SD)and progressive disease(PD).The differences of clinical data of the four groups were compared,and the difference items were brought into Logistic regression equation to analyze the main factors influencing therapeutic efficacy of NAC for breast cancer.Results 85 patients completed the follow-up,including 8 CR cases,49 PR cases,24 SD cases and 4 PD cases.The pathological complete response(PCR)rate of triple negative breast cancer patients was higher than that of Luminal A,Luminal B and Her-2 over expression patients,and the difference was statistically significant(P<0.05).The difference data were brought into Logistic regression equation calculation,and it was found that tumor size,BMI,chemotherapy regimen,chemotherapy cycle,p53 expression and molecular typing of breast cancer were all the main factors influencing therapeutic efficacy of NAC for breast cancer.Conclusion There are many factors that influence therapeutic efficacy of NAC for breast cancer,which are mainly related to tumor size,BMI,chemotherapy regimen,chemotherapy cycle,p53 expression and molecular typing.Meanwhile,patients with their tumor≤5 cm who receive a chemotherapy regimen of paclitaxel combined with anthracyclines for 4-6 chemotherapy cycles,with p53 negative and with the result of breast cancer molecular typing being triple negative type have better therapeutic efficacy than other patients.