乳腺癌新辅助化疗后病理完全缓解的因素分析

目的:研究代谢综合征（metabolic syndrome，MS）与乳腺癌新辅助化疗（neoadjuvant chemotherapy，NAC）病理完全缓解（pathological complete response，pCR）的关系。方法:收集2014年01月至2020年06月在哈尔滨医科大学附属肿瘤医院接受NAC后进行手术的女性乳腺癌患者526例，并收集患者的临床病理资料，根据MS诊断标准分为MS组99例与非MS组427例。采用Logistic回归模型进行单因素和多因素分析MS与pCR的关系。结果:105例患者NAC后获得pCR，其中MS组10例，非MS组95例。单因素分析显示:非MS组较MS组更易获得pCR（P=0.008），激素受体（hormone receptor，HR）阴性、人类表皮生长因子受体2（human epidermal growth factor receptor-2，HER-2）阳性、Ki-67＞14%者更易获得pCR（P＜0.001、P＜0.001、P=0.002）。多因素分析显示:与HR阴性者相比，HR阳性者较难获得pCR（P＜0.001）；与HER-2阴性者相比，HER-2阳性者pCR率更高（P=0.033）；与非MS患者相比，合并MS患者更难获得pCR（P=0.041）。亚组分析显示:非MS组中HR阴性患者更易获得pCR（P＜0.001）。结论:HR状态、HER-2状态及MS是乳腺癌NAC后pCR的独立预测因素，合并代谢综合征的乳腺癌患者接受新辅助化疗后更难获得病理完全缓解，与长期预后相关性有待进一步研究。

Analysis of factors associated with pathological complete remission after neoadjuvant chemotherapy for breast cancer

Objective:To investigate the relationship between metabolic syndrome(MS) and pathological complete response(pCR) in breast cancer patients received neoadjuvant chemotherapy(NAC).Methods:The clinicopathological data of 526 female breast cancer patients who underwent surgery after NAC in the Harbin Medical University Cancer Hospital from January 2014 to June 2020 were collected.According to the MS diagnostic criteria,patients were divided into MS group(n=99),and non-MS group(n=427).Univariate and multivariate analysis of the relationship between MS and pCR was performed with Logistic regression model.Results:105 patients achieved pCR after NAC,including 10 patients in the MS group and 95 patients in the non-MS group.Univariate analysis showed that compared with the MS group,the non-MS group was more likely to reach pCR(P=0.008),and the hormone receptor(HR) negative,human epidermal growt factor receptor-2(HER-2) positive,Ki-67>14% patients were more likely to achieve pCR(P＜0.001,P＜0.001,P=0.002).Multivariate analysis showed that compared with HR negative patients,HR positive patients were more difficult to reach pCR(P＜0.001).Compared with HER-2 negative patients,HER-2 positive patients had higher pCR rate(P=0.033).Compared with non-MS patients,the pCR rate was lower in MS patients(P=0.041).Subgroup analysis showed that HR negative patients in the non-MS group were more likely to achieve pCR(P＜0.001).Conclusion:HR status,HER-2 status and MS are independent predictors of pCR after NAC in breast cancer patients.Breast cancer patients with MS are more difficult to achieve pCR after NAC,and their correlation with long-term prognosis needs further study.