乳腺癌新辅助化疗疗效与临床病理特征、局部复发和远处转移的关系

Relationship between the efficacy of neoadjuvant chemotherapy for breast cancer and clinicopathological features,local relapse and distant metastasis

目的分析乳腺癌新辅助化疗(NAC)的临床疗效与临床病理特征、局部复发和远处转移的关系。方法回顾性分析沧州市中心医院2014年1月至2016年12月就诊的55例患者,按照临床疗效有无pCR分为pCR组和非pCR组,分析乳腺癌患者临床病理特征与病理完全缓解(pCR)的关系和pCR与3年内局部复发和远处转移的关系。结果单因素分析显示,乳腺癌标志物Ki-67水平、HER-2、BRCA1状态和TNBC均是pCR的影响因素(P<0.05);然而,年龄、化疗方案、化疗周期个数和临床分期均不是pCR的影响因素(P>0.05)。NAC后实体瘤疗效:完全缓解(CR)27例(49.1%),部分缓解(PR)17例(30.9%),疾病稳定(SD)4例(7.3%),疾病进展(PD)7例(12.7%)。NAC后,患者pCR率为40.0%;全部患者达到pCR 22例,非pCR 33例;NAC后,pCR组3年局部复发0例,非pCR组3年局部复发17例(51.5%);pCR组3年远处转移0例,非pCR组3年远处转移16例(48.5%)。结论乳腺癌临床病理特征(TNBC、HER-2阳性、Ki-67高表达和BRCA1状态)均与pCR有关。相比非pCR患者,pCR患者预后较好,pCR与患者预后有关。

Objective To analyze the relationship between the clinical efficacy of neoadjuvant chemotherapy(NAC)for breast cancer and clinicopathological features,local relapse and distant metastasis.Methods A retrospective analysis of 55 patients in Cangzhou Central Hospital from January 2014 to December 2016 was performed,and they were divided into pCR group and non-pCR group according to the clinical efficacy of pCR or not.The relationship between clinicopathological characteristics and pathological complete response(pCR)and the relationship between pCR and local recurrence and distant metastasis within 3 years were analyzed in breast cancer patients.Results Univariate analysis showed that the level of breas t cancer marker Ki-67,human epidermal growth factor receptor-2(HER-2),breast cancer susceptibility gene-1(BRCA1)status and triplenegative breast cancer(TNBC)were all influential factors for pCR(P<0.05).However,age,chemotherapy regimen,number of chemotherapy cycles and clinical stage were not factors influencing pCR(P>0.05).After treatment with NAC,solid tumors had completely remitted(CR)in 27 cases(49.1%)and partially remitted(PR)in 17 cases(30.9%),and presented stable(SD)in 4 cases(7.3%)and progressive(PD)in 7 cases(12.7%).After NAC,the pCR rate of the patients was 40.0%;all patients achieved pCR in 22 cases and non-pCR in 33 cases;after NAC,there were 0 cases of local recurrence in the pCR group at 3 years,and 17 cases(51.5%)in the non-pCR group at 3 years;There were 0 cases of distant metastasis in the year,and 16 cases(48.5%)of distant metastasis in the nonpCR group within 3 years.Conclusion Clinicopathological features of breast cancer(TNBC,HER-2 positivity,high expression of Ki-67 and BRCA1 status)are associated with pCR.The pCR patients had a better prognosis than nonpCR patients,indicating that pCR is associated with patient prognosis.