新辅助化疗联合保乳术治疗乳腺癌的疗效观察

Efficacy of neoadjuvant chemotherapy combined with breast conserving surgery for breast cancer

目的探讨新辅助化疗联合保乳术治疗乳腺癌患者的临床疗效及患者雌激素受体(ER)、孕激素受体(PR)和人表皮生长因子受体-2(HER-2)水平变化情况。方法选取2018年1月至2020年1月间武警河南总队医院收治的56例乳腺癌患者纳入研究对象,采用随机数表法将患者分为观察组和对照组,每组28例。观察组采用新辅助化疗联合保乳术治疗,对照组采用乳腺癌根治术治疗。比较两组患者手术相关指标、临床治疗效果以及ER、PR和HER-2水平变化情况。结果观察组患者手术时间和住院时间均短于对照组,术中出血量少于对照组,差异有统计学意义(P<0.05)。观察组患者治疗后总有效率为92.9%,高于对照组的71.4%,差异有统计学意义(P<0.05)。两组患者新辅助化疗前后ER、PR和HER-2表达比较,差异无统计学意义(P>0.05)。ER、PR和HER-2阳性转阴性表达转化率分别为26.7%、36.4%和62.5%。结论新辅助化疗联合保乳术治疗乳腺癌的效果显著,安全性高,ER、PR及HER-2表达变化可作为指导新辅助化疗的重要指标。

Objective To observe the clinical efficacy of neoadjuvant chemotherapy combined with breast conserving surgery for breast cancer and the effects on changes in estrogen receptor(ER),progesterone receptor(PR)and human epidermal growth factor receptor 2(HER-2)levels.Methods Fifty-six patients with breast cancer who received treatment at Henan Armed Police Corps Hospital from January 2018 to January 2020 were included in the study.They were divided into an observation group and a control group with 28 patients in each group using the random number table method.The observation group received neoadjuvant chemotherapy combined with breast conserving therapy and the control group received mastectomy.Surgical related indices,clinical treatment efficacy and changes in ER,PR and HER-2 levels were compared between the two groups.Results The duration of operation,length of hospital stay and intraoperative blood loss were lower in the observation group than in the control group(all P<0.05).The overall efficacy rate was 92.9%in the observation group reached,which was statistically significantly higher than 71.4%of the control group(P<0.05).There was no statistically significant differences in the expression of ER,PR and HER-2 before and after neoadjuvant chemotherapy between the two groups(P>0.05).The conversion rate of ER,PR and HER-2 was 26.7%,36.4%and 62.5%,respectively.Conclusion Neoadjuvant chemotherapy combined with breast conserving surgery is effective and safe for the treatment of breast canc-er,and changes in the expression of ER,PR and HER-2 can be used as important indicators to guide neoadjuvant chemotherapy.