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乳腺癌分子分型在新辅助化疗疗效和预后中的预测作用 被引量:16

The Predicting Value of Molecular Subtype in Response and Prognosis for Breast Cancer Patients with NeoadjuvantChemotherapy
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摘要 [目的]探讨乳腺癌分子分型在新辅助化疗疗效及预后预测中的作用。[方法]对接受新辅助化疗方案治疗的157例乳腺癌患者进行回顾性分析。依据免疫组化雌激素受体(ER)、孕激素受体(PR)、人表皮生长因子受体2(Her2)表达水平将乳腺癌分为Luminal A、Luminal B、Her2阳性和三阴性4个分子分型,分析4个分子分型与临床病理因素、新辅助化疗疗效及3年生存率的相关性。[结果]157例患者中,分子分型与肿瘤大小、淋巴结转移相关,T3~4期的三阴性型的比例高于T1~2期(P=0.003);N0、N1、N2、N3期的三阴性型的比例分别为44.4%、23.8%、25.6%和22.2%(P=0.014)。不同分子分型间新辅助化疗有效率无明显差异(P=0.632),而T分期(P=0.014)、N分期(P=0.031)与有效率明显相关。不同分子分型间新辅助化疗3年生存率有明显差异,Luminal A型最高,三阴性型最低(P=0.049)。乳腺癌预后影响因素Cox回归模型分析提示分子分型(P=0.003)、年龄(P=0.007)、T分期(P=0.013)、N分期(P=0.000)是乳腺癌患者的独立预后因素。[结论]乳腺癌分子分型与肿瘤大小、淋巴结转移状态相关,能作为新辅助化疗远期疗效的独立预测因子。 [Purpose] To investigate the predicting value of molecular subtype in the response and outcome of breast cancer patients received neoadjuvant chemotherapy.[Methods] One hundred and fifty-seven patients undergoing neoadjuvant chemotherapy were enrolled retrospectively.Bosed on the expression of estrogen receptor(ER),progesterone receptor(PR),human epidermal growth factor receptor 2(Her2) expression level,the cases were divided into 4 subtypes,Luminal A,Luminal B,Her2+ and triple-negative phenotype.The correlation between molecular subtypes and clinic pathologic factors,efficacy of neoadjuvant chemotherapy and 3-year survival were analyzed.[Results] Of the 157 patients,molecular subtypes correlated with tumor size and lymph node metastasis.The cases with T3 ~4 had a higher proportion than those with T1~2 in triple-negative phenotype(P=0.003).The proportion of triple-negative phenotype in cases with N0,N1,N2 and N3 was 44.4%,23.8%,25.6% and 22.2% respectively with significant difference(P=0.014).No significant difference between the molecular subtypes and the efficacy of neoadjuvant chemotherapy(P = 0.632).However,T stage(P=0.014) and N stage(P=0.031) related to the efficacy.Obvious difference were found among 4 molecular subtypes in 3-years survival,Luminal A was the highest,triple-negative phenotype was the lowest(P=0.049).Cox regression showed that molecular subtype(P=0.003),age(P=0.007),T stage(P=0.013),N stage(P=0.000) were the independent prognostic factors in patients with breast cancer.[Conclusion] The breast cancer molecular subtypes relate to the tumor size and lymph node metastasis,those could be used as the independent predictor for the efficacy of neoadjuvant chemotherapy.
作者 雷蕾 王晓稼 杨红健 谢尚闹 孟旭莉 陈占红 许沈华 LEI Lei,WANG Xiao-Jia,YANG Hong-jian,et al.(Zhejiang Cancer Hospital,Hangzhou 310022,China)
机构地区 浙江省肿瘤医院
出处 《中国肿瘤》 CAS 2012年第11期868-873,共6页 Bulletin of Chinese Cancer
基金 浙江省医药卫生科技计划项目(2010KYA041) 浙江省公益性技术应用研究计划项目(2010C33017)
关键词 乳腺癌 分子分型 新辅助化疗 预测因子 breast cancer molecular subtype neoadjuvant chemotherapy predictor
作者简介 通讯作者:许沈华。E-mail:shenhuaxu@hotmail.com
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参考文献11

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