不同分子分型乳腺癌新辅助化疗后缓解率的差异性研究

目的 探讨新辅助化疗对不同分子分型乳腺癌的疗效.方法 选取本院2007年6月-2014年6月本院收治的122例乳腺癌患者,明确其肿瘤分期,免疫组织化学技术明确ER、PR、HER2及Ki-67表达状况,并分为腺腔A型（Luminal A）、腺腔B型（LuminalB）、HER2型、基底细胞型（Basal-like）,采用阿霉素联合多西紫杉醇类方案（ET方案）对所有患者进行2周期的新辅助化疗,判断肿瘤治疗效果及患者毒副反应发生情况.结果 新辅助化疗后总有效人数为40例,占总人数的32.79％,其中Lurninal A型总有效率为9.10％ （3/33）,Luminal B型总有效率为12.9％（4/31）,HER2型总有效率为53.8％（14/26）,Basal-like型总有效率为59.4％（19/32）.腺腔A型与腺腔B型的总有效率差异无统计学意义（P＞0.05）,HER2型与基底细胞型总有效率差异无统计学意义（P＞0.05）,而HER2型与基底细胞型的总有效率均高于腺腔A型与腺腔B型,差异有统计学意义（P＜0.05）.不同分子分型乳腺癌患者化疗中均出现不同程度的化疗副反应,未出现导致化疗中断的副反应.结论 不同分子分型的乳腺癌患者采用ET方案新辅助化疗的疗效不同,乳腺癌分子分型可能是乳腺癌治疗具有价值的依据之一,较Luminal而言,HER2型与Basal-like型患者的总有效率更高.

Effects of neoadjuvant chemotherapy on different molecular subtypes of breast cancer

Objective To explore the effects of neoadjuvant chemotherapy on different molecular subtypes of breast cancer. Methods 122 confirmed breast cancer patients were collected as the research object, and cancer stage of all the patients were determined. Molecular subtypes were constructed from immunohistochemical results of ER, PR, HER2 and Ki - 67 status, and they were divided into Luminal A type, Luminal B type, HER2 type and Basal - like type. All the patients received two cycles of doxorubicin combined with docetaxel scheme （ET scheme） therapy. The therapeutic effect and adverse reaction of patients were evaluated. Results After neoadjuvant chemotherapy, total effective rate was 3.79% （40/122）, thus in Luminal A, Luminal B, HER2 type andBasal - liketypegroup, thetotaleffectiveratewas9.10 % （ 3/33 ）, 12.9 % （ 4/31 ）, 53.8 % （14/26） and 59.4 % （19/32）. There was no significant difference of total efficiency rate between Luminal A and luminal B （P 〉 0.05）, and there was no significant difference of total efficiency rate between HER2 and Basal - like type group as well （P 〉 0.05）. The total effective rate of HER2 type and basal - like type group was significantly higher than that of Luminal type groups （ P 0.05）. Different types of chemo - therapy associate side effect occurred in different molecular typi- cal group. None of chemotherapy was interrupted by serious side effect. Conclusion The therapy -effect of different molecular subtypes breast cancer treated by neoadjuvant chemotherapy of ET scheme is different, the molecular classification of breast cancer may be one of the valuable bases for the treatment of breast cancer. Compared with Luminal subtypes, the total efficiency is higher in HER2 and Basal - like subtype groups.