乳腺癌术前经桡动脉插管灌注化疗的临床和病理学研究

Clinical and pathology analysis of pre-operative chemotherapy through radial artery on breast carcinoma

目的探讨术前桡动脉灌注化疗在Ⅱb-Ⅲb期乳腺癌治疗中的意义。方法 315例Ⅱb-Ⅲb期乳腺癌随机分为A组(术前经桡动脉CAP方案灌注化疗)和B组(术前无化疗),评定A组的临床疗效与病理组织学反应。对比两组的5年存活率及无病存活率。检测两组肿瘤细胞的细胞凋亡指数。结果 A组乳腺肿瘤与腋淋巴结临床有效率为80.2%与77.6%组织学反应显效率92.6%。A组和B组的5年存活率为77.8%和63.4%,5年无病存活率为72.2%和56.9%;细胞凋亡指数为19.37±6.49和9.2±5.04。差异有统计学意义(P〈0.05)结论术前桡动脉灌注化疗能有效地提高对乳腺肿瘤及腋窝淋巴结的局部临床控制率,提高远期疗效。

Objective To evaluate the value of pre-operalive chemotherapy through radial artery as a step of comprehensive treatment of stage Ⅱ b-Ⅲ b breast carcinoma.Methods 315 cases with stage Ⅱ b—Ⅲ b breast carcinoma were divided into pre-operative chemotherapy group(162 cases) received pre-operalive chemotherapy through radial artery by CAP and control group(153 cases).Several factors including pathological response,local recurrence,apoptotic index,disease-free survival(DFS) and overall survival(OS) were analyzed.Results The effective rale of primary lesion was 80.2%.The axillary melastalic lymph nodes was 77.6%.The pathological response was 92.6%.The 5-year survival rate and the 5-year disease-free survival rate were 77.8%vs 63.4 and 72.2%vs 56.9%,the apoptolic indexes were 19.37±6.49 and 9.2±5.04,respectively,for pre-operative chemotherapy group and the control group(P<0.05).Conclusion Pre-operative chemotherapy through radial artery on breast carcinoma can effectively give good locoregional control rate and increase the forward effect.It can induce opoptosis of breast carcinoma