新辅助化疗后乳腺癌患者乳房病理完全缓解及腋窝淋巴结非病理完全缓解相关临床研究

Clinical study on breast pCR and axillary lymph node non-pCR in patients with breast cancer after neoadjuvant chemotherapy

目的:分析乳腺癌患者经新辅助化疗(Neoadjuvant chemotherapy,NACT)后乳房病灶病理完全缓解(Pathologic complete response,pCR)而腋窝转移淋巴结非病理完全缓解(Non-pathologic complete response,nonpCR)的生存预后状况及相关风险因素。方法:选取2015年7月至2019年7月本院乳腺外科收治的乳腺癌新辅助化疗患者53例为研究对象,根据术后患者乳房病灶及腋窝淋巴结病理缓解情况分为两组:A组:乳房病灶non-pCR而腋窝转移淋巴结pCR 31例;B组:乳房病灶pCR而腋窝转移淋巴结non-pCR 22例,分析两组患者病理资料及随访情况。结果:两组患者年龄、绝经情况以及肿瘤大小差异无统计学意义(P>0.05),疾病类型差异有统计学意义(P<0.05),A组患者以Her-2阳性型为主,B组患者以三阴性型为主;A组患者2年复发率为16.1%,低于B组患者68.2%,生存时间长于B组患者,差异均有统计学意义(P<0.001);腋窝淋巴结分期、肿瘤大小是B组患者疾病进展的危险因素(P<0.001);腋窝转移淋巴结分期越高,患者的无进展生存期(Progression-free-survival,PFS)越短(P<0.05)。结论:新辅助化疗后乳房病灶pCR而腋窝转移淋巴结non-pCR患者比乳房病灶non-pCR而腋窝转移淋巴结pCR患者复发转移风险更高,生存预后更差,且腋窝淋巴结分期、肿瘤大小是乳房病灶pCR而腋窝转移淋巴结non-pCR患者的疾病进展危险因素。

Objective:To analyze the survival prognosis and related risk factors of breast lesion which recahed pathologic complete response(pCR)and axillary metastatic lymph node,and got non-pCR in patients with breast cancer after neo-adjuvant chemotherapy(NACT).Methods:The postoperative pathological data and follow-up of breast cancer patients(53 cases)treated with neoadjuvant chemotherapy in The First Affiliated Hospital of Gannan Medical University from July 2015 to July 2019 were analyzed.They were divided into Group A(31 cases,breast lesion non-pCR and axillary metastatic lymph node pCR)and Group B(22 cases,pCR and axillary metastatic lymph node non-pCR).Results:Age,menopausal status,and tumour size between the two groups were with no statistical significance(P>0.05);the differ⁃ence in disease types was with statistical significance(P<0.05).Patients in Group A were mainly Her-2 positive;pa⁃tients in Group B were manly triple negative.The 2-year recurrence rate in Group A was 16.1%,lower than that of Group B(68.2%).The survival time in Group A was longer than that of Group B,the difference was statistically significant(P<0.001).Axillary lymph node staging and tumor size were the risk factors of tumour progression in Group B(P<0.001).The higher the lymph node staging of axillary metastasis,the shorter the progression-free-survival(P<0.05).Conclusion:The survival prognosis of breast cancer patients with breast pCR and axillary metastatic lymph node non-pCR after neoadjuvant chemotherapy is worse with worse survival prognosis.Axillary lymph node staging and tumor size are the risk factors of thedisease progress of these patents.