Luminal A型乳腺癌新辅助化疗疗效的影响因素分析

Influencing factors of neoadjuvant chemotherapy for Luminal A type breast cancer

目的探讨影响Luminal A型乳腺癌患者新辅助化疗疗效的相关因素,从而为Luminal A型乳腺癌患者新辅助化疗提供筛选指标,最终为提高新辅助化疗疗效提供参考依据。方法回顾性分析2013年8月23日—2019年11月1日于我院接受术前新辅助化疗并进行手术治疗的Luminal A型乳腺癌患者的临床资料,共计191例患者符合入组标准,采用RECIST1.1评分评估疗效,根据临床有效情况分为CR+PR组和非CR+PR组,分析临床病理特征与疗效的关系以及影响疗效的相关因素。结果191例Luminal A型乳腺癌患者中临床有效147例(CR+PR组147例)、无效44例(非CR+PR组患者),临床有效率77.0%。腋窝淋巴结降级率达26.8%(45/168),年龄≤50岁、绝经前状态、雌激素受体(ER)<70%、孕激素受体(PR)<50%及肿块位于外侧象限与患者临床有效率有关(P<0.05)。Logistic回归分析结果显示,肿块位置及临床分期是影响Luminal A型乳腺癌患者新辅助化疗后取得临床有效的独立影响因素(P<0.05)。结论分布于外侧象限及临床分期为Ⅲ期Luminal A型乳腺癌患者新辅助化疗更易取得临床获益,因此Luminal A型乳腺癌患者行新辅助化疗前可进行评估筛选从而提高疗效。

Objective The aim of this study was to explore the related factors affecting the efficacy of neoadjuvant chemotherapy in patients with Luminal A type breast cancer,so as to provide screening indicators for patients with Luminal A type breast cancer and ultimately provide reference for improving the efficacy of neoadjuvant chemotherapy.Methods The clinical data of patients with Luminal A type breast cancer who received preoperative neoadjuvant chemotherapy and surgical treatment in our hospital from August 23,2013 to November 1,2019 were retrospectively analyzed.A total of 191 patients with type A breast cancer met the inclusion criteria.RECIST1.1 score was used to evaluate the efficacy.According to the clinical efficacy,these patients were divided into the Cr+PR group and non Cr+PR group.The relationship between clinicopathological features,efficacy and the related factors affecting efficacy were analyzed.Results Amongst 191 cases of Luminal A type breast cancer,147 cases were clinically effective(147 in the CR+PR group 44 cases were not clinically effective(44 cases in the non-CR+PR group),and the clinical effective rate of 77.0%.The degradation rate of axillary lymph nodes was 26.8%(45/168).Age≤50 years old,premenopausal state,estrogen receptor(ER)<70%,progesterone receptor(PR)<50%and tumor located in the lateral quadrant were associated with the clinical effective rate(P<0.05).Logistic regression analysis showed that tumor location and clinical stage were independent factors affecting the clinical efficacy of neoadjuvant chemotherapy in patients with Luminal A type breast cancer(P<0.05).Conclusion Patients with Luminal A type breast cancer distributed in the lateral quadrant and clinical stageⅢare more likely to be clinically effective,and patients with Luminal A type breast cancer can be evaluated and screened before neoadjuvant chemotherapy,so as to improve the curative effect.