新辅助化疗对局部进展期乳腺癌的临床疗效以及细胞和血管组织学的影响

目的 研究采用TEF方案的新辅助化疗对局部进展期乳腺癌的临床疗效和细胞增殖、微血管密度和组织学分级的影响。方法 24例局部进展期乳腺癌患者接受TEF新辅助化疗二个疗程后进行手术切除,应用免疫组化S-P染色法分别检测24例行新辅助化疗的患者和24例对照组患者手术切除的乳腺癌标本的增殖细胞核抗原(Proliferating cellnuclear antigen,PCNA标记指数以及肿瘤组织的微血管密度(Microvessel Density,MVD),对两组患者的HE染色标本进行组织学分级,并对临床疗效进行分析。结果 新辅助化疗组中临床CR2例,PR21例,NR 1例,病理CR 1例,PR 22例,NR1例。两组比较PCNA标记指数有显著差异(P<0.01),MVD和组织学分级也均有显著差异(P<0.05)。结论 采用TEF新辅助化疗方案近期临床疗效明显,可以显著地抑制乳腺癌细胞的增殖,减少新生血管的生成,降低组织学的分级。

Study on clinical effect of neoadjuvant chemotherapy in local advanced breast cancer and in the role of cells and vascular histology

Objective To evaluate the clinical effect of neoadjuvant chemotherapy with taxotere- epirubicin-5-fluorouracil (TEF) on local advanced breast cancer and the role on cell proliferation, microvessel density and histological grade. Methods Twenty-four patients underwent operations after receiving two cycles of TEF chemotherapy repeated every 21 days. The expression of Proliferating cell nuclear antigen (PCNA) and the microvessel density was examined by S-P immunohistochemical staining with breast cancer tissues of 24 cases in the neoadjuvant chemotherapy group and 24 cases in the control group. The histological grade of patients was classified according to H-E stained tissue sections. The clinical effect was assessed. Results Clinically, two cases showed CR, 21 cases PR, 1 case NR, and pathologically 1 case showed CR, 22 cases PR, 1 case NR in the neoadjuvant chemotherapy group. There was significant difference of PCNA labeled index between the two groups (P < 0. 01) . The MVD and histological grade between the two groups had significant difference too(P < 0. 05) . Conclusion The short-term clinical effect of neoadjuvant chemotherapy with TEF is very significant, which can greatly inhibit cancer cell proliferation, decrease neovascularization and lower histological grade.