新辅助化疗后 ER、PR由阴转阳乳腺癌患者内分泌治疗的疗效观察

目的：探讨新辅助化疗（ NACT）后雌激素受体（ ER）、孕激素受体（ PR）由阴转阳乳腺癌患者内分泌治疗的临床疗效。方法78例乳腺癌新辅助化疗后ER、PR由阴转阳患者，按随机数字表法分为内分泌治疗组42例及传统治疗组36例。内分泌治疗组在术后口服三苯氧胺10 mg/次，2次/d；传统治疗组术后不予内分泌治疗。观察两组患者的随访效果并对两组的3年、5年生存率和总生存率进行比较。结果内分泌治疗组复发转移16例（38．1％），各种原因死亡11例（26．2％）；传统治疗组复发转移22例（61．1％），各种原因死亡18例（50．0％），内分泌治疗组的复发转移率、死亡率均低于传统治疗组（P均＜0．05）；内分泌治疗组的3年、5年无病生存率分别为73．8％（31/42）、61．9％（26/42），总生存率分别为83．3％（35/42）、73．8％（31/42）；传统治疗组3年、5年无病生存率分别为50．0％（18/36）、38．9％（14/36），总生存率分别为61．1％（22/36）、50．0％（18/36）。内分泌治疗组3年、5年无病生存率及总生存率均高于传统治疗组（ P均＜0．05）。结论内分泌治疗可有效地提高新辅助化疗后ER、PR由阴转阳的乳腺癌患者的生存率，降低复发转移率及死亡率。

Curative Effect of Endocrine Therapy on Breast Cancer Patients with Estrogen Receptor,Progesterone Receptor from Negative to Positive after Neoadjuvant Chemotherapy

Objective To study the curative effect of endocrine therapy on the treatment of breast cancer patients with estrogen receptor（ER）,progesterone receptor（PR） from negative to positive after neoadjuvant chemotherapy （NACT）. Methods Seventy-eight breast cancer patients with ER ,PR from negative to positive after NACT were randomly divided into the endocrine therapy group of 42 cases and the traditional treatment group of 36 cases according to the random number table.The patients in the endocrine therapy group were given oral tamoxifen after operation （10 mg/time,2 times/d）,while the patients in the traditional treatment group didn′t recieved endocrine therapy after operation .The curative effects of patients in two groups were observed ,and the 3-,5-year survivals and total survivals of two group were compared .Results There were 16 cases（38.1%） of recurrence/metastasis and 11 cases（26.2%） of various causes of death in the endocrine therapy group,while 22 cases（61.1%） of recurrence/metastasis and 18 cases（50.0%） of various causes of death in the traditional treatment group,the recurrence/metastasis rate,mortality of endocrine therapy group were lower than those of traditional treatment group （all P〈0.05）.The 3-,5-year disease-free survivals（DFS） of endocrine therapy group were 73.8%（31/42）,61.9%（26/42）,respectively,and the total survivals were 83.3%（35/42）,73.8%（31/42）,respectively. The 3-,5-year DFS of traditional treatment group were 50.0%（18/36）,38.9%（14/36）,respectively,the total survivals were 61.1%（22/36）,50.0%（18/36）,respectively.The 3-,5-year DFS and total survivals of endocrine therapy group were higher than those of traditional treatment group（all P〈0.05）.Conclusion Endocrine therapy can improve the survival rate,reduce the recurrence/metastasis rate and mortality of breast cancer patients with ER ,PR from negative to positive after neoad-juvant chemotherapy .