多西紫杉醇联合吡柔比星新辅助化疗治疗不同亚型乳腺癌患者的疗效及病理完全缓解状况分析

摘要

目的 探究不同亚型乳腺癌患者采用多西紫杉醇联合比柔比星(TE)新辅助化疗治疗的临床疗效以及病理完全缓解(pCR)的影响因素及其对患者预后的意义.方法 回顾我院2013年2月至2016年2月收治的不同亚型乳腺癌患者120例治疗情况,所有患者根据免疫组织化学表达分为Luminal A型 、Luminal B型 、人表皮生长因子受体2(HER-2)过表达型以及三阴性型四种分子亚型各30例,分析患者治疗后临床效果以及pCR影响因素及对患者预后的意义.结果 HER-2过表达型以及三阴性型患者在采用TE新辅助化疗后,临床有效率以及病理有效率分别为73%、63%及87%、80%,明显高于Luminal A型以及Luminal B型患者,二者数据差异具有统计学意义(P<0.05),120例患者中,59例符合病理完全缓解标准,肿瘤PR阴性HER-2阳性以及Ki67的高表达等均是pCR的独立预测因素,并且HER-2阳性患者以及三阴性型患者在经过治疗后pCR率明显高于Luminal A型及Luminal B型(HER-2阴性)患者,二者比较差异具有统计学意义(P<0.05).结论 TE新辅助化疗在对患者进行治疗后效果良好,并且pRC可作为HER-2过表达型以及三阴性型患者远期预后的重要预测指标.%Objective To investigate the clinical efficacy of TE neoadjuvant chemotherapy in patients with different subtypes of breast cancer and the prognostic factors of pathological complete response (pCR) and its prognostic significance .Methods To review the treatment of 120 patients with different subtypes of breast cancer in our hospital from February 2013 to February 2016 ,and all the patients were divided into four groups :Luminal A ,Luminal B ,HER-2 overexpression ,and Triple-Negative types ,with 30 cases in each group .And the clinical outcome ,the factors influencing pCR and the prognostic significance of the patients were analyzed .Results After TE neoadjuvant chemotherapy ,HER-2 overexpression and Triple-Negative patients were observed ,and the clinical effective rate and pathological effective rate were 73 .3% ,63 .3% and 86 .7% ,80% ,respectively ,which were higher than those of Lumina A and Luminal B patients ,and the difference between the two groups was statistically significant ( P < 0 .05) .Of the 120 patients ,59 met the criteria for pathological complete remission ,and tumor PR negative ,HER-2 positive ,and high expression of Ki67 were independent predictors of pCR ,and the rates of pCR in HER-2 positive patients and Triple-Negative patients were significantly higher than those in patients with Lu-minal A and B (HER2 negative) after treatment( P < 0 .05) .Conclusion TE neoadjuvant chemotherapy is effec-tive in the treatment of patients ,and pCR can be used as an important predictor of long-term prognosis of HER-2 overexpression and triple-negative patients .