晚期Luminal型乳腺癌孕激素受体表达状况与化疗疗效相关性研究

目的孕激素受体(progesterone receptor,PR)表达状况与乳腺癌内分泌治疗疗效有明确的相关性,本研究探讨PR表达状况是否也与晚期Luminal型乳腺癌化疗疗效相关。方法选取2011-03-01-2016-12-30临沂市肿瘤医院术后复发一线化疗的晚期Luminal型乳腺癌患者为研究对象,应用吉西他滨联合顺铂(GP)方案进行化疗。66例晚期Luminal型乳腺癌患者分为PR低表达组(阳性率<20%)38例和PR高表达组(阳性率≥20%)28例,均给予GP方案化疗。吉西他滨1 000mg/m^2,静脉滴入,d1、d8;顺铂25mg/m^2,静脉滴入,d1~d3。21d为1个周期,每2个周期评价疗效,共化疗2~8个周期。化疗期间出现病情进展或不能耐受的患者停止化疗。化疗结束后的患者内分泌治疗维持,直至疾病进展。结果 PR低表达组38例,完全缓解(complete response,CR)0例,部分缓解(partial response,PR)11例(28.9%),疾病稳定(stable disease,SD)25例(65.8%),疾病进展(progressive disease,PD)2例(5.3%),总有效率(CR+PR)为28.9%;PR高表达组28例,CR 2例(7.1%),PR 13例(46.4%),SD13例(46.4%),PD 0例,总有效率(CR+PR)为53.6%。2组总有效率差异有统计学意义,χ^2=5.313,P=0.021。PR低表达组和高表达组中位无进展生存期分别为9(95%CI:7.6~10.9)和12个月(95%CI:9.2~13.4),差异无统计学意义,χ^2=1.505,P=0.220。结论 PR低表达的晚期Luminal型乳腺癌患者一线GP方案化疗近期疗效差,疾病进展时间短。

Correlation between progesterone receptor expression and the efficacy of GP chemotherapy in advanced luminal breast cancer

OBJECTIVE Progesterone receptor(PR)expression is clearly correlated to endocrinotherapy efficacy,in this study,the author intended to examine whether PR expression is correlated to chemotherapy efficacy.METHODS Patients with advanced Luminal breast cancer,who received first-line chemotherapy for postoperative recurrence,admitted to Linyi Tumor Hospital from March 1 st,2011 to December 30 th,2016 were selected as the research objects.The combined regimen of Gemcitabine and Cisplatin was administered for chemotherapy.Sixty-six patients with advanced Luminal breast cancer were divided into two groups:PR low expression and PR high expression.All patients were given GP chemotherapy regimen:Gemcitabine 1000 mg/m2,d1,d8,Cisplatin 25 mg/m2,d1-d3,21 days as a cycle,the efficacy was evaluated every 2 cycles.There were altogether 2-8 chemotherapy cycles.Patients who progressed or were intolerant during chemotherapy were stopped the chemotherapy.Endocrinotherapy was maintained in patients after chemotherapy,until the disease progressed.RESULTS There were 38 cases in the PR low expression group,0 cases for CR,11 cases for PR(28.9%),25 cases for SD(65.8%),2 cases for PD(5.3%),and the total effective rate(CR+PR)was 28.9%.There were 28 cases in the PR high expression group,2 cases for CR(7.1%),13 cases for PR(46.4%),13 cases for SD(46.4%),0 cases for PD,and the total effective rate(CR+PR)was 53.6%(χ^2=5.313,P=0.021),indicating that the difference was statistically significant.The median progression free survivals(PFSs)of the PR low expression group and the PR high expression group were 9 months(95%CI:7.6-10.9)and 12 months(95%CI:9.2-13.4)respectively(χ^2=1.505,P=0.220),suggesting that the difference was not statistically significant.CONCLUSION The shortterm efficacy of GP regimen in patients with advanced Luminal breast cancer with low PR receptor expression is poor,and the time to progression is short.