乳腺癌分子分型在新辅助化疗疗效及预后预测中的作用

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:收集漯河市中心医院收治的236例接受新辅助化疗患者的临床病理资料,分为Luminal A、Luminal B、Her-2阳性和三阴乳腺癌4种分子分型,分析分子分型与临床病理因素、新辅助化疗疗效及 5 年生存率的相关性.结果:236例患者中,107例(45.3%)为Luminal A亚型,47例(19.9%)为Luminal B亚型,27例(11.4%)为Her-2阳性亚型,55例(23.3%)为三阴乳腺癌亚型.Her-2阳性(25.9%)及三阴乳腺癌亚型(30.9%)的病理完全缓解(pCR)率明显高于Luminal亚型(Luminal A亚型 4.7%及Luminal B亚型 8.5%),差异有统计学意义(P<0.05).与Luminal亚型相比,Her-2阳性及三阴乳腺癌亚型具有更差的5年无病生存和总生存(P<0.01);获得pCR的乳腺癌患者的5年无病生存和总生存明显高于化疗后仍有癌残留的患者(P<0.05).结论:相对于Luminal亚型,Her-2 阳性和三阴乳腺癌亚型对新辅助化疗更为敏感,更易达到pCR;但是Her-2阳性和三阴乳腺癌亚型预后反而更差.

Predictive role of breast cancer molecular subtype in response and outcome of breast cancer patients treated with neoadjuvant chemotherapy

Objective:To investigate the predictive role of breast cancer molecular subtype in the response and outcome of breast cancer patients treated with neoadjuvant chemotherapy.Methods:We collected the data of 236 patients with primary breast cancer treated with neoadjuvant chemotherapy in Luohe Central Hospital in this retrospective study.The patients were classified into 4 subtypes:Luminal A,Luminal B,Her-2 positive and triple-negative.The correlation between molecular subtypes and clinic pathologic factors,efficacy of neoadjuvant chemotherapy and 5-year survival were analyzed.Results:Among all 236 patients,107(45.3%) patients were Luminal A subtype,47(19.9%) were Luminal B subtype,27(11.4%) were Her-2 positive subtype and 55(23.3%) were triple-negative subtype.The pCR rates of Her-2 positive(25.9%) and triple-negative(30.9%) subtypes were higher than those of Luminal subtype(Luminal A 4.7% and Luminal B 8.5%),with significant difference(P<0.05).Despite initial chemosensitivity,the patients with Her-2 positive and triple-negative subtypes had worse 5-year disease-free survival(DFS) and 5-year overall survival(OS)(P<0.01) than those with Luminal subtypes in the whole population.The 5-year DFS and OS of patients who achieved pathological complete response(pCR) were significantly higher than those of patients with residual disease after chemotherapy(P<0.05).Conclusion:Breast cancer patients with Her-2 positive and triple-negative subtypes have higher sensitivity to neoadjuvant chemotherapy and with higher rates of pCR but worse prognosis than those with Luminal subtypes.