乳腺癌新辅助化疗残余肿瘤组织病理信息与预后分析

目的探讨乳腺癌新辅助化疗前后肿瘤组织病理信息的变化及对预后的影响。方法对2014年1月—2016年5月就诊于辽宁省肿瘤医院乳腺外科并行规范乳腺癌新辅助化疗的177例患者回顾性分析,探讨乳腺癌新辅助化疗前后肿瘤组织病理信息的变化,并分析残余肿瘤组织病理信息对无病生存期(DFS)和总生存期(OS)的影响。结果 177例乳腺癌患者中位随访时间为37个月,37个月无病生存率和总生存率分别为84.0%和95.0%,4年无病生存率和总生存率分别为79.7%和81.1%。新辅助化疗后乳腺癌患者的DFS独立危险因素为原始T分期、原始N分期、存在脉管侵袭、新辅助化疗后Ki-67增加。OS的独立危险因素为原始T分期、原始N分期。而新辅助化疗前后ER状态的改变、PR状态的改变、HER-2状态的改变与患者预后无关(P>0.05)。结论乳腺癌新辅助化疗前后分子生物学指标ER、PR、HER-2、Ki-67可以发生改变,但与乳腺癌患者预后无关。原始肿瘤T分期、原始肿瘤N分期、存在脉管侵袭和Ki-67增加是影响乳腺癌患者DFS的危险因素。原始肿瘤T分期、原始肿瘤N分期是影响乳腺癌患者OS的危险因素。

Analysis of histopathological information and prognosis of residual tumor in neoadjuvant chemotherapy for breast cancer

Objective The aim of this study was to explore the changes of tumor histopathological information of breast cancer before and after neoadjuvant chemotherapy and its effect on prognosis.Methods A retrospective analysis of 177 patients with breast cancer undergoing neoadjuvant chemotherapy who were admitted to the Department of Breast Surgery of Liaoning Cancer Hospital from January 2014 to May 2016 was conducted to determine the changes of tumor histopathological information before and after neoadjuvant chemotherapy.The effects of residual tumor histopathological information on disease-free survival(DFS)and overall survival(OS)were analyzed.Results The median follow-up time of 177 breast cancer patients was 37 months.The 37-month disease-free survival rate and overall survival rate were 84.0% and 95.0%,respectively.The 4-year disease-free survival rate and overall survival rate were 79.7% and 81.1%,respectively.The independent risk factors of DFS in breast cancer patients after neoadjuvant therapy were the original T stage,the original N stage,the presence of vascular invasion,and increasing Ki-67 after neoadjuvant chemotherapy.The independent risk factors of OS were the original T stage and the original N stage.The changes of ER status,PR status and HER-2 status before and after neoadjuvant chemotherapy were not related to the prognosis of patients(P＞0.05).Conclusion The molecular biological indexes ER,PR,HER-2 and Ki-67 can be changed for breast cancer before and after neoadjuvant chemotherapy,but it has nothing to do with the prognosis of breast cancer patients.The T stage of the original tumor,the N stage of the original tumor,the presence of vascular invasion and the increasing Ki-67 are the risk factors that affect the DFS of patients with breast cancer.The original tumor T stage and N stage are the risk factors that affect the OS of patients with breast cancer.