乳腺癌分子分型在新辅助化疗疗效和预后中的预测作用 |
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引用本文: | 雷 蕾,王晓稼,杨红健.乳腺癌分子分型在新辅助化疗疗效和预后中的预测作用[J].中国肿瘤,2012,21(11):868-873. |
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作者姓名: | 雷 蕾 王晓稼 杨红健 |
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作者单位: | 浙江省肿瘤医院,浙江杭州,310022 |
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基金项目: | 浙江省医药卫生科技计划项目(2010KYA041);浙江省公益性技术应用研究计划项目(2010C33017) |
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摘 要: | 目的]探讨乳腺癌分子分型在新辅助化疗疗效及预后预测中的作用.方法]对接受新辅助化疗方案治疗的157例乳腺癌患者进行回顾性分析.依据免疫组化雌激素受体(ER)、孕激素受体(PR)、人表皮生长因子受体2(Her2)表达水平将乳腺癌分为Luminal A、Luminal B、Her2阳性和三阴性4个分子分型,分析4个分子分型与临床病理因素、新辅助化疗疗效及3年生存率的相关性.结果] 157例患者中,分子分型与肿瘤大小、淋巴结转移相关,T3~4期的三阴性型的比例高于T1~2期(P=0.003);N0、N1、N2、N3期的三阴性型的比例分别为44.4%、23.8%、25.6%和22.2% (P=0.014).不同分子分型间新辅助化疗有效率无明显差异(P=0.632),而T分期(P=0.014)、N分期(P=0.031)与有效率明显相关.不同分子分型间新辅助化疗3年生存率有明显差异,Luminal A型最高,三阴性型最低(P=0.049).乳腺癌预后影响因素Cox回归模型分析提示分子分型(P=0.003)、年龄(P=0.007)、T分期(P=0.013)、N分期(P=0.000)是乳腺癌患者的独立预后因素.结论]乳腺癌分子分型与肿瘤大小、淋巴结转移状态相关,能作为新辅助化疗远期疗效的独立预测因子.
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关 键 词: | 乳腺癌 分子分型 新辅助化疗 预测因子 |
收稿时间: | 2012/8/11 0:00:00 |
The Predicting Value of Molecular Subtype in Response and Prognosis for Breast Cancer Patients with Neoadjuvant Chemotherapy |
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Institution: | LEI Lei,WANG Xiao-Jia,YANG Hong-jian,et al.(Zhejiang Cancer Hospital,Hangzhou 310022,China) |
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Abstract: | Purpose] To investigate the predicting value of molecular subtype in the response and outcome of breast cancer patients received neoadjuvant chemotherapy.Methods] One hundred and fifty-seven patients undergoing neoadjuvant chemotherapy were enrolled retrospectively.Bosed on the expression of estrogen receptor(ER),progesterone receptor(PR),human epidermal growth factor receptor 2(Her2) expression level,the cases were divided into 4 subtypes,Luminal A,Luminal B,Her2+ and triple-negative phenotype.The correlation between molecular subtypes and clinic pathologic factors,efficacy of neoadjuvant chemotherapy and 3-year survival were analyzed.Results] Of the 157 patients,molecular subtypes correlated with tumor size and lymph node metastasis.The cases with T3 ~4 had a higher proportion than those with T1~2 in triple-negative phenotype(P=0.003).The proportion of triple-negative phenotype in cases with N0,N1,N2 and N3 was 44.4%,23.8%,25.6% and 22.2% respectively with significant difference(P=0.014).No significant difference between the molecular subtypes and the efficacy of neoadjuvant chemotherapy(P = 0.632).However,T stage(P=0.014) and N stage(P=0.031) related to the efficacy.Obvious difference were found among 4 molecular subtypes in 3-years survival,Luminal A was the highest,triple-negative phenotype was the lowest(P=0.049).Cox regression showed that molecular subtype(P=0.003),age(P=0.007),T stage(P=0.013),N stage(P=0.000) were the independent prognostic factors in patients with breast cancer.Conclusion] The breast cancer molecular subtypes relate to the tumor size and lymph node metastasis,those could be used as the independent predictor for the efficacy of neoadjuvant chemotherapy. |
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Keywords: | breast cancer molecular subtype neoadjuvant chemotherapy predictor |
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