炎性乳腺癌新辅助化疗疗效和影响因素分析

目的探讨炎性乳腺癌（IBC）的分子生物学特点与新辅助化疗疗效的关系及影响化疗疗效的相关因素。方法收集2005年1月至2013年6月收治的103例术前化疗的IBC患者临床资料，应用免疫组织化学方法检测乳腺癌组织的雌激素受体（ER）、孕激素受体（PR）、人表皮生长因子受体2（HER-2）及E钙黏蛋白（E—cadherin）的表达，评价IBC新辅助化疗的疗效。结果103例IBC患者ER阴性48例，PR阴性51例，HER．2阳性45例，E．cadherin阳性66例。总体化疗有效率为72．8％（75／103），联合紫杉类为主化疗方案的患者（紫杉组，62例）化疗有效率显著高于蒽环类为主化疗方案的患者（蒽环组，41例）[80．6％（50／62）比61．0％（25／41）]，差异有统计学意义（P〈0．05）；ER阴性、PR阴性、E—cadherin阴性的患者化疗有效率均显著高于其对应的ER阳性、PR阳性、E—cadherin阳性的患者[83．3％（40／48）比63．6％（35／55）、82．4％（42／51）比63．5％（33／52）、83.8％（31／37）比66．7％（44／66）]，差异有统计学意义（P〈0．05）；紫杉组E—cadherin阳性表达的患者化疗有效率显著高于蒽环组[77．5％（31／40）比50．0％（13／26）]，差异有统计学意义（P〈0．05）；HER-2的表达与炎性乳腺癌患者的化疗疗效无相关性（P〉0．05）。结论ER、PR及E—cadherin阴性的患者对IBC患者化疗敏感，E．cadherin的阳性表达可能是影响IBC患者化疗耐药的重要因素，选择含紫杉类药物联合化疗方案有助于提高E．cadherin阳性IBC患者的化疗疗效。

Analysis of influence factors on neoadjuvant chemotherapy efficacy in inflammatory breast cancer

Objective To explore the relationship of molecular biology characteristic and the treatment outcome, and influence factors of neoadjuvant chemotherapy （NAC） in inflammatory breast cancer （IBC）. Methods The clinicopathological data of 103 IBC patients who were treated with NAC from January 2005 to June 2013 were analyzed retrospectively. Immunohistochemical method was used to detect the expression of estrogen receptor （ ER ）, progesteron receptor （PR）, human epidermal growth factor receptor 2 （HER-2） and E-cadherin. The treatment outcome were evaluated. Results In 103 IBC patients, ER negative was 48 patients, PR negative was 51 patients, HER-2 positive was 45 patients, E- eadherin positive was 66 patients. The effective rate of chemotherapy was 72.8% （75/103）. The effective rate of chemotherapy in taxane-based group was significantly higher than that in anthracycline-based group [ 80.6% （50/62） vs. 61.0%（25/41 ） ], and there was significant difference （P 〈 0.05 ）. The effective rate of chemotherapy in ER, PR, E-eadherin negative patients was significantly higher than that in ER,PR, E-cadherin positive patients [83.3%（40/48） vs. 63.6%（35/55）,82.4%（42/51 ） vs. 63.5%（33/52）,83.8%（31/37） vs. 66.7%（44/66） ],and there was significant difference （P 〈 0.05 ）. The effective rate of chemotherapy in taxane-based group with E-cadherin positive patients was significantly higher than that in anthracycline-based group with E-cadherin positive patients [77.5% （31/40） vs. 50.0% （13/26）] （P 〈 0.05）. No correlation existed between the expression of HER-2 and the treatment outcome of chemotherapy （P 〉 0.05）. Conclusion ER,PR and E-cadherin negative patients with IBC is chemosensitive to NAC. The positive expression of E-cadherin may be an important factor of chemotherapy resistance. For the patients with E-cadherin positive,taxane-based chemotherapy regimen can achieve a better effective rate.