| 影响青年乳腺癌患者新辅助化疗后病理完全缓解和预后的病理因素分析 |
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| 引用本文： | 艾勇彪1,' target='_blank'>2,黄 军1,' target='_blank'>2,章书铭1,' target='_blank'>2,李文仿1,张丹峰1,' target='_blank'>2. 影响青年乳腺癌患者新辅助化疗后病理完全缓解和预后的病理因素分析[J]. 现代肿瘤医学, 2022, 0(10): 1781-1786. DOI: 10.3969/j.issn.1672-4992.2022.10.013 |
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| 作者姓名： | 艾勇彪1 ' target='_blank'>2 黄 军1 ' target='_blank'>2 章书铭1 ' target='_blank'>2 李文仿1 张丹峰1 ' target='_blank'>2 |
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| 作者单位： | 1.湖北医药学院附属太和医院甲乳外科，湖北 十堰 442000；2.湖北医药学院附属太和医院武当山院区女性肿瘤外科，湖北 十堰 442714 |
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| 基金项目： | 湖北省教育厅科学技术研究项目(编号:B2019109) |
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| 摘 要： | 目的:探讨影响青年乳腺癌患者新辅助化疗（neoadjuvant chemotherapy，NAC）后病理完全缓解（pathological complete response，pCR）和预后的临床病理因素。方法:回顾性分析2010年01月至2018年12月我院甲乳外科收治年龄≤35岁行NAC的女性乳腺癌患者的临床病理资料。NAC后依据Miller-Payne评分系统，将患者分为pCR组和非pCR组。探讨临床病理因素对青年乳腺癌患者pCR、复发转移和死亡的影响，同时分析pCR与无病生存期（disease free survival，DFS）与总生存期（overall survival，OS）之间的相关性。结果:168例患者中pCR 37例,pCR率为22.0%。体质量指数(body mass index,BMI)、术前淋巴结状态、雌激素受体（estrogen receptor，ER）、孕激素受体（progesterone receptor，PR）、人类表皮生长因子受体2（human epidermal growth factor receptor-2，HER-2）、Ki-67、p53及分子分型与青年乳腺癌患者NAC后的pCR率关系密切（P＜0.05）。肿瘤大小、术前淋巴结状态、ER、PR、HER-2、p53及分子分型影响患者的复发转移和死亡（P＜0.05），同时肿瘤大小、术前淋巴结状态、组织学分级、ER、PR、HER-2、Ki-67及分子分型均是DFS和OS的独立影响因素（P＜0.05）。66例复发转移患者中pCR患者7例，占pCR患者的18.9%（7/37），pCR组和非pCR组DFS比较差异具有统计学意义（P＜0.05）。38例死亡患者中pCR患者3例，占pCR患者的8.1%（3/37），pCR组和非pCR组OS比较差异具有统计学意义（P＜0.05）。结论:影响青年乳腺癌患者pCR和预后的临床病理因素较多，获得pCR的患者具有更好的远期预后。
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| 关 键 词： | 青年乳腺癌 新辅助化疗 病理完全缓解 预后 |
Analysis of the pathological factors influencing the pathological complete response and prognosis of young breast cancer patients after neoadjuvant chemotherapy |
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| AI Yongbiao1,' target='_blank'>2,HUANG Jun1,' target='_blank'>2,ZHANG Shuming1,' target='_blank'>2,LI Wenfang1,ZHANG Danfeng1,' target='_blank'>2. Analysis of the pathological factors influencing the pathological complete response and prognosis of young breast cancer patients after neoadjuvant chemotherapy[J]. Journal of Modern Oncology, 2022, 0(10): 1781-1786. DOI: 10.3969/j.issn.1672-4992.2022.10.013 |
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| Authors: | AI Yongbiao1 ' target='_blank'>2 HUANG Jun1 ' target='_blank'>2 ZHANG Shuming1 ' target='_blank'>2 LI Wenfang1 ZHANG Danfeng1 ' target='_blank'>2 |
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| Affiliation: | 1.Department of Breast and Thyroid Surgery,Taihe Hospital,Affiliated Hospital of Hubei University of Medicine,Hubei Shiyan 442000,China;2.Female Oncology Surgery,Wudang Mountain Campus of Taihe Hospital,Affiliated Hospital of Hubei University of Medicine,Hubei Shiyan 442714,China. |
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| Abstract: | Objective:To investigate the clinicopathological factors that influencing the pathological complete response （pCR） and prognosis in young patients with breast cancer after neoadjuvant chemotherapy (NAC).Methods:From January 2010 to December 2018,the clinicopathological data of female breast cancer patients with≤35 years old who received NAC and were admitted to the department of breast and thyroid surgery of our hospital were retrospectively analysed.According to Miller-Payne scoring system after NAC,the patients were divided into pCR group and no-pCR group.The influence of clinicopathological factors on pCR,recurrence,metastasis and death of young breast cancer patients was explored,and the correlation between pCR and disease free survival (DFS),overall survival (OS) was analysed.Results:After NAC,pCR was obtained in 37 of 168 patients,and the pCR rate was 22.0%.Body mass index (BMI),preoperative lymph node status,estrogen receptor (ER),progesterone receptor (PR),human epidermal growth factor receptor-2 (HER-2),Ki-67,p53 and molecular typing were closely related to pCR in young breast cancer patients after NAC (P＜0.05).Tumor size,preoperative lymph node status,ER,PR,HER-2,p53 and molecular typing affected the recurrence,metastasis and death of patients (P＜0.05).Meanwhile,tumor size,preoperative lymph node status,histologic grades,ER,PR,HER-2,Ki-67 and molecular typing were independent influencing factors of DFS and OS (P＜0.05).There were 7 patients with pCR in 66 patients with recurrence and metastasis,accounting for 18.9%(7/37) of pCR patients.The difference in DFS between the pCR group and the no-pCR group was statistically significant (P＜0.05).Among the 38 dead patients,there were 3 patients with pCR,accounting for 8.1%(3/37) of the pCR patients,and there was difference in OS between the pCR group and the no-pCR group (P＜0.05).Conclusion:There are many clinicopathological factors affecting pCR and prognosis in young breast cancer patients,and patients with pCR have better long-term prognosis. |
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| Keywords: | young breast cancer neoadjuvant chemotherapy pathological complete response prognosis |
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