HER-2阳性乳腺癌患者新辅助化疗联合曲妥珠单抗治疗的影响因素及预后分析

目的:探讨人类表皮生长因子受体（human epidermal growth factor receptor 2，HER-2）阳性乳腺癌患者应用新辅助化疗联合曲妥珠单抗的疗效及其预后的影响因素。方法:选取2014年01月01日至2018年12月31日郑州市第三人民医院乳腺甲状腺外科收治经穿刺病理证实为乳腺癌的患者151例，免疫组化结果均显示为HER-2阳性，并行新辅助化疗，根据患者经济条件及意愿选择是否接受曲妥珠单抗治疗，将其分为单纯新辅助化疗组（neoadjuvant chemotherapy,NAC）94例，新辅助化疗联合曲妥珠单抗组（NAC+H）57例，对比两组患者无病生存期（disease-free survival，DFS）和总生存期（overall survival，OS）情况，并分析影响预后的相关因素。结果: 151例HER-2阳性乳腺癌患者中，NAC+H组患者DFS（P=0.046）和OS（P=0.026）均明显优于NAC组，两组比较差异具有统计学意义。术前淋巴结状态、术后淋巴结状态、肿瘤大小、MP分级是影响患者DFS和OS的主要影响因素（P值分别为0.032、0.018、0.038、0.010）。结论:接受新辅助化疗联合曲妥珠单抗的HER-2阳性乳腺癌患者预后较好，两组在新辅助治疗后肿瘤大小、淋巴结状态及MP分级结果存在明显差异，该结果对选择合理的治疗方案、判断预后有重要作用。

Prognosis and influencing factors of neoadjuvant chemotherapy combined with trastuzumab in breast cancer patients with positive HER-2

Objective:To investgate human epidermal growth factor receptor positive joint of application neoadjuvant chemotherapy in patients with breast cancer by the curative effect of bead sheet resistance and its influence factors of prognosis.Methods:From January 1,2014 to December 31,2018,151 patients admitted to the thyroid and breast surgery department of the Third People's Hospital of Zhengzhou were selected.The immunohis to chemical results were all positive for HER-2,and received chemotherapy.According to patients' economic conditions and willingness to choose whether to receive trastuzumab treatment,94 patients were divided into neoadjuvant chemotherapy alone group(NAC).According to whether they received trastuzumab or not,neoadjuvant chemotherapy combined with trastuzumab(NAC+H) in 57 patients.The occurrence of disease-free survival and ovarall survival were compared between the two groups,and relevant prognostic factors were analyzed.Results:Among the 151 cases with positive HER-2 breast cancer,both DFS(P=0.046) and OS(P=0.026) in the NAC+H group were significantly better than those in the NAC group,and the difference between the two groups was statistically significant.Preoperative lymph node status,postoperative lymph node status,tumor size,MP grading were the main influencing factor of patients' DFS and OS（P=0.032,0.018,0.038,0.010）.Conclusion:Breast cancer patients with positive HER-2 who received neoadjuvant chemotherapy combined with trastuzumab has a better prognosis.There are significant differences in tumor size,lymph node status and MP grading between the two groups.The results are significant for the selection of appropriate treatment regimens,prognosis is important.