炎性乳腺癌临床病理特征与化疗疗效及预后的相关性分析

摘要

目的:探讨炎性乳腺癌(inflammatory breast cancer,IBC)患者临床病理特征与新辅助化疗疗效及预后的相关关系.方法:回顾性分析天津医科大学肿瘤医院2010年1月至2013年12月收治且接受新辅助化疗的81例IBC患者临床资料,应用单因素及多因素统计学方法分析其临床病理特征对化疗疗效及预后的影响.结果:所有患者3年总生存(OS)率和无病生存(DFS)率分别为53.1％和37.0％,患者接受新辅助化疗后的病理完全缓解(pathologic complete response,pCR)率为13.6％(11/81).新辅助化疗后是否达到pCR与患者的病理类型和分子分型有关(P<0.05),但获得pCR并不会改善其预后(P>0.05),而IBC患者的术前淋巴结分期是OS和DFS的独立影响因素(均P<0.05),新辅助化疗方案和淋巴管癌栓情况是影响患者DFS的独立因素(P<0.05).结论:IBC的临床病理特征影响患者对化疗的敏感性,同时通过对术前淋巴结分期和淋巴管癌栓状态的评估,可以预测疾病的预后,合理使用新辅助化疗方案,以期达到最佳的治疗效果.%Objective: To investigate the relationship of clinicopathological characteristics with neoadjuvant chemotherapeutic efficacy and prognosis of inflammatory breast cancer (IBC) patients. Methods: Medical records of 81 patients who underwent neoadjuvant chemotherapy for IBC in Tianjin Medical University Cancer Institute and Hospital between January 2010 and December 2013, were retrospectively analyzed. Clinicopathological features, response to neoadjuvant chemotherapy, and prognostic factors were studied by univariate and multivariate analyses. Results: The 3-year overall survival rate (OS) and disease-free survival rate (DFS) of patients were 53.1％ and 37.0％, respectively. The pathologic complete response (pCR) rate of patients after accepting neoadjuvant chemotherapy was 13.6％ (11/81). Statistically significant association was observed between pCR and pathological types in IBC (P<0.05). However,pCR had no benefit in improving the clinical outcomes of IBC patients (P>0.05). Preoperative lymph node stage was an independent prognostic factor of overall survival (OS) and disease- free survival (DFS) in IBC patients (P<0.05). Neoadjuvant chemotherapy and lymph vessel tumor emboli were independent factors of DFS (all P<0.05). Conclusion: Clinicopathological characteristics of IBC patients affected chemosensitivity. We could predict the prognosis of these patients by preoperative lymph node stage and lymph vessel tumor emboli and select chemotherapy to achieve the best curative effect.