乳腺癌新辅助化疗方案的疗效与临床病理特点的关系

Analysis of the correlation between the efficacy of neoadjuvant chemotherapy and the clinicopathological characteristics of breast cancer

目的分析乳腺癌新辅助化疗方案的化疗疗效与乳腺癌临床病理特点的关系。方法收集159例接受新辅助化疗的乳腺癌患者的临床资料,其中40例患者接受蒽环类为主的新辅助化疗方案(对照组),119例患者接受蒽环类联合紫杉类的新辅助化疗方案(观察组),分析和比较蒽环类为主与蒽环类联合紫杉类的新辅助化疗方案的疗效与临床病理特点的关系。结果对照组的临床有效率为72.5%(29/40),临床无效率为27.5%(11/40),病理完全缓解率为2.5%(1/40);观察组临床有效率为89.0%(106/119),临床无效率为11.0%(13/119),病理完全缓解率为10.1%(12/119)。进一步分析两组的临床有效率差异有统计学意义(χ^(2)=6.418,P=0.011),而病理完全缓解率差异无统计学意义(P=0.187)。而在肿瘤最大径>5 cm(P=0.010)、腋窝淋巴结转移阳性(P=0.046)、激素受体(HR)表达阳性(P=0.004)、Ki-67表达>30%(P=0.049)亚组中观察组优于对照组的临床疗效。结论在乳腺癌肿瘤最大径>5 cm、腋窝淋巴结转移阳性、激素受体表达阳性、Ki-67表达>30%亚组中紫衫类联合蒽环类的乳腺癌新辅助化疗方案的临床疗效可能优于蒽环类新辅助化疗方案,但是两种新辅助化疗方案的病理完全缓解无明显差别。

Objective To analyze the correlation between the clinical efficacy of different regimens of neoadjuvant chemotherapy for breast cancer and the clinicopathological characteristics of breast cancer.Methods The clinical data of 159 breast cancer patients who received neoadjuvant chemotherapy in our hospital were collected.Among them,40 patients received anthracycline neoadjuvant chemotherapy and 119 patients received anthracycline combined with taxane.Analyze and compare The correlations between the efficacy of neoadjuvant chemotherapies and the clinicopathological characteristics was analyzed and compared.Results In the anthracycline neoadjuvant chemotherapy group,the clinical effective rate of was 72.5%(29/40),the clinical ineffectiveness was 27.5%(11/40),and the pathological complete remission rate was 2.5%(1/40).In the combination of anthracyclines and taxane neoadjuvant chemotherapy group,the clinically effective rate was 89.0%(106/119),the clinically ineffective rate was 11.0%(13/119)and the pathological complete remission rate was 10.1%(12/119).Further analysis found that the clinical efficacies of neoadjuvant chemotherapy between anthracyclines and anthracyclines combined with taxane was significantly different(χ^(2)=6.418,P=0.011),but there was no significant difference in pathological complete remission rate(pCR,P=0.187).When the tumor diameter was greater than 5cm(P=0.010);axillary lymph node metastasis was positive(P=0.046);hormone receptor(HR)was positive(P=0.004);and Ki-67 expression was greater than 30%(P=0.049);the clinical efficacy of neoadjuvant chemotherapy with anthracyclines combined with taxane was significantly better than anthracyclines.Conclusion When breast cancer tumor diameter is greater than 5cm,axillary lymph node metastasis is positive,hormone receptor expression is positive,Ki-67 expression is greater than 30%,the clinical efficacy of neoadjuvant chemotherapy for breast cancer anthracyclines combined with taxane may be better than that of anthracyclines.But there is no significant difference in pathological complete remission between the two neoadjuvant chemotherapy schemes.