TOPⅡa 基因扩增对蒽环类药物在 HER2阳性乳腺癌新辅助化疗中的疗效预测

摘要

目的：研究 TOPⅡa 基因扩增对蒽环类药物在 HER2阳性乳腺癌新辅助化疗中对于疗效的预测作用。方法：选择我院2007-2010年间216例 HER2阳性乳腺癌新辅助化疗患者，均给予 TAC（多西他赛+吡柔比星+环磷酰胺）方案进行化疗。依据 TOPⅡa 基因扩增状态将患者分为扩增组与非扩增组，对比组间客观有效率及病理完全缓解率差异。结果：HER2为3+者的客观有效率及病理完全缓解率优于2+/1+者。TOPⅡa 基因扩增患者的 ORR 及 pCR%显著优于非扩增组（74.6% vs.21.5%，38.8% vs.2.7%，P <0.001）。亚组分析中发现，在 HER2表达一定时，TOPⅡa 基因扩增情况对以蒽环类为基础的新辅助化疗方案的疗效仍具有预测作用。结论：HER2阳性乳腺癌对蒽环类有良好的临床疗效可能归因于肿瘤组织中 TOPⅡa 基因的扩增。%Objective:To investigate the effect of TOPⅡa amplification on anthracycline - based neoadjuvant chemotherapy in HER2 positive breast cancer. Methods:To collect the clinical information of 216 patients suffered from HER2 positive breast cancer who received TAC regimen(docetaxel,pirarubicin and cyclophosphamide). All ca-ses were separated into TOPⅡa amplification group and lack of TOPⅡa amplification group. We compared the differ-ences of ORR and pCR% between two groups. Results:HER2(3 + )patients had higher ORR and pCR% than HER2(2 + / 1 + )patients. TOPⅡa amplification group had higher ORR and pCR% than lack of TOPⅡa amplifica-tion group(74. 6% vs. 21. 5% ,38. 8% vs. 2. 7% ,P < 0. 001). In the subgroup analysis,TOPⅡa amplification could predict response of anthracycline - based neoadjuvant chemotherapy in HER2 positive breast cancer. Conclusion:The reason why anthracycline could improve the clinical effect of HER2 positive breast cancer may be attributed to TOPⅡa amplification in the tumor tissue.