乳腺癌新辅助化疗后不同退缩方式肿瘤的形态学及分子生物学特征比较研究

摘要

Objective To evaluate the breast cancer shrinkage modes after neoadjuvant chemotherapy and corre-sponding morphological and molecular biological characteristics.Methods There were 22 patients with histologically con-firmed breast cancer from January 2011 to December 2014 were collected. All patients were examined with dynamic en-hancement magnetic resonance imaging before neoadjuvant chemotherapy and after four cycles neoadjuvant chemotherapy,underwent radical mastectomy within two weeks after neoadjuvant chemotherapy. The correlation breast cancer shrinkage mode with lesion subtypes and chemotherapy reaction classification and molecular biological characteristics were analyzed with independent sample t test and the Fisher's exact test, respectively. Results Of 22 invasive ductal carcinoma, after neoadjuvant chemotherapy,14 patients presented concentric shrinkage,8 patients presented multi-concentric shrinkage.The cancer shrinkage proportion of the concentric group and multi-concentric group were 71.8%±28.3% and 38.7%±24.8%,re-spectively.There was significant difference in shrinkage volume between concentric group and multi-concentric group (t=2.757,P=0.012).The tumors with concentric shrinkage on MRI showed more mass lesions (11/14,78.6%)and the tumors with multi-concentric shrinkage showed more nonmass lesions(6/8,75%)after neoadjuvant chemotherapy,which was signifi-cant between the 2 groups (P=0.026).There were no significant differences in chemotherapy reaction classification,estrogen receptor(ER),progesterone receptor(PR),human epidermalgrowth factor receptor-2(HER2),p53,Ki-67,and molecular types between breast cancer shrinkage modes (P>0.05). Conclusions The breast cancer shrinkage modes after neoadjuvant chemotherapy correlate with morphology characteristics of breast cancers before neoadjuvant chemotherapy.The tumors with concentric shrinkage on MRI present more mass lesions and the tumors with multi-concentric shrinkage present more non-mass lesions.%目的 评价乳腺癌新辅助化疗后不同退缩方式肿瘤的形态学及分子生物学特征.方法 收集2011年1月—2014年12月间于我院经组织学确诊为乳腺癌的病人22例,均于新辅助化疗前、化疗4周期后行乳腺动态增强MRI检查,化疗结束2周内行乳腺癌根治术.分析化疗后肿瘤的退缩方式,并分别采用独立样本t检验和Fisher确切概率法比较不同退缩方式的肿瘤体积退缩比例以及肿瘤的病变类型、化疗反应分度和肿瘤分子生物学特征指标的差异.结果22例乳腺浸润性导管癌经新辅助化疗后有14例表现向心性退缩,8例表现多中心退缩.向心性退缩组与多中心退缩组乳腺癌的肿瘤体积退缩比例分别为71.8%±28.3%和38.7%±24.8%,两组间差异有统计学意义(t=2.757,P=0.012).向心性退缩组多表现为肿块型病变(11/14,78.6%),多中心退缩组多表现为非肿块型病变(6/8,75%),不同退缩方式肿瘤的病变类型间差异有统计学意义(P=0.026).不同退缩方式肿瘤的化疗反应分度、雌激素受体和孕激素受体表达情况、HER2、p53、Ki-67和分子分型间差异均无统计学意义(均P>0.05).结论 乳腺癌新辅助化疗后不同的退缩方式与治疗前肿瘤的形态有关,乳腺癌新辅助化疗后向心性退缩多为肿块型病变,多中心退缩多为非肿块型病变.