乳腺癌分子分型与新辅助化疗疗效关联性分析

目的乳腺癌在分子水平上特异性明显,新辅助化疗在其治疗上扮演的角色越来越重要。本研究旨在探讨乳腺癌分子分型与新辅助化疗疗效的相关性。方法回顾性分析2011-01-01-2015-12-31新疆医科大学附属肿瘤医院382例初治行新辅助化疗的乳腺癌患者的临床和病理资料,用免疫组化方法检测ER、PR、HER2和Ki-67的表达情况,判定分子分型,分析乳腺癌分子分型与新辅助化疗疗效的相关性。结果 Luminal型、HER2过表达型及三阴性型乳腺癌与临床疗效评价(χ^2=19.608,P<0.001)及病理疗效评价(χ^2=60.470,P<0.001)差异均有统计学意义的关联。三阴性型较HER2过表达型有更好组织学显著反应(χ^2=30.673,P<0.001),HER2过表达型较Luminal B型有更好的组织学显著反应,χ^2=25.480,P<0.001。临床疗效评价与病理疗效评价一致性欠佳(Kappa值≤0.40)。结论乳腺癌分子分型与新辅助化疗疗效有统计学意义的关联,HER2过表达型和三阴性型对新辅助化疗更敏感;临床疗效评价与病理疗效评价一致性欠佳。

Correlation analysis between molecular typing and neoadjuvant chemotherapy in 382 cases of breast cancer

OBJECTIVE Breast cancer has obvious specificity at the molecular level,and neoadjuvant chemotherapy plays an increasingly important role in its treatment.The purpose of this study was to investigate the correlation between the molecular typing of breast cancer and the efficacy of neoadjuvant chemotherapy.METHODS The clinical and pathological data of 382 breast cancer patients newly treated with neoadjuvant chemotherapy in the affiliated cancer hospital of Xinjiang medical university on January 1 st,2011 and December 31 st,2015 were retrospectively analyzed.The expressions of ER,PR,HER2 and Ki-67 were detected by immunohistochemistry and the molecular typing was determined.Analysis the correlation between the molecular classification of breast cancer and the efficacy of neoadjuvant chemotherapy.RESULTS Luminal type,HER2 overexpression type and triple-negative breast cancer have statistically significant correlation with clinical efficacy evaluation(χ^2=28.001,P=0.001)and pathological efficacy evaluation(χ^2=72.671,P<0.001).Triple-negative breast cancer has better histological response than HER2 overexpression type(χ^2=30.673,P<0.001),HER2 over expression type has better histological response than Luminal B type(χ^2=25.480,P<0.001).The consistency between clinical and pathological efficacy evaluation was poor(Kappavalue≤0.40).CONCLUSIONS There was a statistically significant correlation between the molecular classification of breast cancer and the efficacy of neoadjuvant chemotherapy.HER2 over expression type and triple-negative type were more sensitive to neoadjuvant chemotherapy and could achieve better efficacy.The consistency between clinical and pathological efficacy evaluation was poor.