Peng Jianheng, Song Junlong, Li Hongyuan. Predictors of pathological complete response after neoadjuvant chemotherapy for breast cancer[J]. Journal of Chongqing Medical University, 2014,38(12):1778-1783.
Peng Jianheng, Song Junlong, Li Hongyuan. Predictors of pathological complete response after neoadjuvant chemotherapy for breast cancer[J]. Journal of Chongqing Medical University, 2014,38(12):1778-1783.DOI:
目的:探讨乳腺癌患者的一般临床因素和癌组织免疫组化(immunohistochemistry,IHC)对新辅助化疗(neoadjuvant che-motherapy,NAC)(多西他赛+表柔比星/吡柔比星+环磷酰胺)后达到病理完全缓解(pathological complete response,pCR)的预测作用。方法:对2012年1月1日到2012年12月31日接受NAC的257例乳腺癌患者进行回顾性分析,采用卡方检验和logistic回归分析对一般临床因素及IHC分子的表达水平进行比较。结果:257例患者中,pCR率为16.3%。单因素分析:年龄、月经情况、平均体质指数(body mass index,BMI)、血型等与pCR无相关性,肿瘤分期T1(P=0.006)、雌激素受体(estrogen receptor,ER)阴性(P=0.000)、孕激素受体(progesterone receptor,PR)阴性(P=0.013)、Ki67(增殖分数>30%,P=0.004)和生育1个孩子(P=0.032)与pCR有相关性。多因素分析:生育1个孩子(OR=3.926,95%CI=1.040~14.821)、双阴性乳腺癌[(double negative breast cancer,DNBC),ER、PR均为阴性;OR=7.248,95%CI=2.453~21.416]和Ki67>30%(OR=4.355,95%CI=1.513~12.537)是pCR的独立预测因素。结论:生育1个孩子、DNBC和Ki67>30%对蒽环类NAC更容易取得pCR。生育史是新发现的NAC非常重要的预测因素。
Abstract
Objective:To discuss the general clinical factors for patients with breast cancer and to identify predicting function of im-munohistochemistry(IHC) for pathological complete response after neoadjuvant chemotherapy(NAC) (docetaxel + epirubicin/ pirarubicin + cyclophosphamide). Methods:From 1 January 2012 to 31 December 2012,257 patients treated with NAC were included in this retrospective study.Data were compared using Chi-square,Fisher’s exact tests,likelyhood ratio or multivariate analysis of variance,etc. Results:Of the 257 breast cancer patients receiving NAC,42(16.3%) gained pCR. Five factors were associ-ated with pCR:tumor grade T1(P=0.006),estrogen receptor negative(P=0.000),progesterone receptor negative(P=0.013),Ki67(proliferation scores >30%,P=0.004) and giving birth to one child(P=0.032). In multivariate analysis,double negative breast cancer(DNBC)(OR=7.248,95%CI=2.453 to 21.416),Ki67(proliferation scores >30%,OR=4.355,95%CI=1.513 to 12.537),giving birth to one child(OR=3.926,95%CI=1.040 to 14.821)were found to significantly correlate with pCR. Conclusion:DNBC,Ki67(prolifera-tion scores >30%),giving birth to one child are more likely to experience pCR to NAC. Childbearing history is newly identified as an important predictor.
关键词
乳腺癌新辅助化疗病理完全缓解T分期免疫组化生育史
Keywords
breast cancerneoadjuvant chemotherapypathological complete responsetumor gradeimmunohistochemistrychildbear-ing history