乳腺癌新辅助化疗疗效与分子分型的关系

目的探讨乳腺癌分子分型与表柔比星联合多西他赛（TE）方案新辅助化疗疗效的关系。方法根据纳入和排除标准，共纳入我院2011年5月至2012年12月期间至少接受过3周期TE方案治疗的乳腺癌患者共239例，其各项临床指标均完整。根据免疫组织化学雌激素受体（ER）、孕激素受体（PR）、人表皮生长因子受体2（HER-2）及Ki-67表达水平将患者分为4种亚型，分别为luminal A型、luminalB型、HER-2阳性型和三阴型。分析不同亚型乳腺癌患者的各项相关指标，如病理完全缓解（pCR）率、年龄、月经状态等。结果239例患者中，luminalA型67例（28．03％），luminalB型84例（35．15％），HER．2阳性型21例（8．79％），三阴型67例（28．03％）。4型乳腺癌患者的年龄、月经状态、肿瘤大小、淋巴结状态等临床病理指标差异均无统计学意义（P〉0．05）。三阴型对TE方案的新辅助化疗的pCR率（14．93％）最高，其次依次为luminalB型（7．14％）、HER-2阳性型（4．76％）及luminalA型（1．49％），差异有统计学意义（P=0．027）。结论三阴型相对luminalA型、luminalB型和HER-2阳性型对TE方案的新辅助化疗治疗更敏感，pCR率最高，治疗时需根据患者不同的分子亚型来选用特定的治疗方案。

Relation Between Molecular Subtypes and Neoadjuvant Chemotherapy Efficacy in Breast Cancer

Objective To explore the relation between the molecular subtypes and efficacy ofneoadjuvant chemo- therapy with docetaxel together with epirubicin （TE） in breast cancer. Methods According to the inclusion and exclusion criteria, 239 patients with breast cancer who at least received 3 cycles of TE-based neoadjuvant chemotherapy from May 2011 to December 2012 in this hospital were included. Molecular subtypes were categorized into luminal A, luminal B, human epidermal growth factor receptor 2 （HER-2） positive, and triple negative by the immunohistochemical results of estrogen receptor （ER）, progesterone receptor （PR）, HER-2, and Ki-67 status. The relevant indicators of the different molecular subtypes of breast cancer patients, such as pathological complete response （pCR） rate, age, and menstruation, etc. were analyzed. Results There were 67 （28.03%） patients with luminal A, 84 （35. 15%） luminal B, 21 （8.79%） HER-2, and 67 （28.03%） triple negative in these 239 patients with breast cancer. The differences of age, menstruation, axillary lymph node status etc. among the four molecular subtypes were not statistically significant （P〉0. 05）. The pCR rate of triple negative breast cancer （14. 93%） was the highest among four subtypes, followed by luminal B （7. 14 %）, HER-2 positive （4.76%） and luminal A （1.49%）, there was a significant difference （P：0. 027）. Conclusions Comparing with luminal A, luminal B, and HER-2 positive breast cancers, triple negative breast cancer is the most sensitive to TE neoad- juvant chemotherapy, and it has the highest pCR rate. Therefore, different treatment should be selected according to molecular subtypes of breast cancer.