不同分子亚型的晚期乳腺癌化疗疗效观察

目的：观察不同分子亚型的晚期乳腺癌对多西紫杉醇联合顺铂化疗方案的反应性、疾病进展时间（TTP）及生存时间，进一步评估不同分子亚型乳腺癌的临床特征及预后。方法：利用免疫组化方法将2000年元月至2006年10月收治的62例晚期乳腺癌分为3种分子亚型，62例多西紫杉醇联合顺铂方案化疗，回顾性分析3种亚型乳腺癌的化疗反应性、疾病进展时间及生存期。结果：62例患者中，Basal—like亚型为14例（22．6％），HER2＋／ER一亚型（16．1％），Luminal亚型38例（61．3％）。Basal—like亚型有效率为64．3％，HER2＋／ER一亚型为60．0％，Luminal亚型为47．4％（P=0．551），3者之间无显著性差异。Basal—like亚型，ITI’P为3．2个月，HER2＋／ER一亚型为5．3个月，Luminal亚型为10．1个（P=0．005），Basal—like亚型生存时间为7．0个月，HER2-4-／ER-亚型为11．3个月，Luminal亚型为19．8个（P=0．004），3者在TTP及生存时问存在显著性差异。结论：不同分子亚型的晚期乳腺癌对多西紫杉醇联合顺铂化疗方案的反应性相似，但Basal-like亚型和HER2＋／ER-亚型具有较短的疾病进展时间和生存期，Basal-like亚型的预后最差。原因可能主要与它的生物学特征更具侵袭性有关。

Chemosensitivity of different advanced breast cancer subtypes

Objective：To observe the clinical outcomes of time to progression（TIP）, survival time and response to combination chemotherapy with doeetaxel（DXL） and cisplatin（DDP） for different molecular subtypes of advanced breast cancer and the clinical characteristics and prognoses of different molecular subtypes of breast cancer. Methods： Immunohistoehemieal studies were performed to identify the subtypes of 62 advanced breast cancer. We retrospectively analyzed the clinical outcomes of TIP and survival time and response to chemotherapy of different molecular subtypes for advanced breast cancer. Results： Of the 62 patients tested, 14 （ 22.6% ） were Basal - like , 10（ 16.1% ） were ER2 ＋/ER -, and 38 （61.3%） were Luminal. The response rate of patients with Basal - like was 64.3%, HER2 ＋/ER - was 60.0%, and Luminal was 47.4%. （P -- 0. 551 ）. This rate did not differ significantly among three subtypes. TIP of patients with Basal - like was 3.2 months, HER2 ＋/ER - was 5.3 months and Luminal was 10.1months （ P = 0.005 ）. Survival time of patients with Basal - like was 7.0 months, HER2 ＋/ER - was 11.3 months and Luminal was 19.8 months （P = 0. 004）. They differed significantly among three subtypes. Conclusion： Despite the similar response to combination chemotherapy with DXL and DDP for different molecular subtypes of ad- vanced breast cancer,the Basal- like subtype and HER2 ＋/ER- subtype had a shorter rlTp and survival time than patients with Luminal subtype. The Basal - like subtype showed the poorest prognoses.