高级搜索

乳腺癌临床病理指标以及分子分型对TEC新辅助化疗病理完全缓解的预测价值

李小龙, 成宏, 赵晨晖, 涂刚

李小龙, 成宏, 赵晨晖, 涂刚. 乳腺癌临床病理指标以及分子分型对TEC新辅助化疗病理完全缓解的预测价值[J]. 肿瘤防治研究, 2013, 40(06): 599-603. DOI: 10.3971/j.issn.1000-8578.2013.06.023
引用本文: 李小龙, 成宏, 赵晨晖, 涂刚. 乳腺癌临床病理指标以及分子分型对TEC新辅助化疗病理完全缓解的预测价值[J]. 肿瘤防治研究, 2013, 40(06): 599-603. DOI: 10.3971/j.issn.1000-8578.2013.06.023
LI Xiaolong, CHENG Hong, ZHAO Chenhui, TU Gang. Predictive Values of Clinicopathological Parameters and Molecular Typing for Pathological Complete Response (pCR) in Breast Cancer Neoadjuvant Chemotherapy by TEC[J]. Cancer Research on Prevention and Treatment, 2013, 40(06): 599-603. DOI: 10.3971/j.issn.1000-8578.2013.06.023
Citation: LI Xiaolong, CHENG Hong, ZHAO Chenhui, TU Gang. Predictive Values of Clinicopathological Parameters and Molecular Typing for Pathological Complete Response (pCR) in Breast Cancer Neoadjuvant Chemotherapy by TEC[J]. Cancer Research on Prevention and Treatment, 2013, 40(06): 599-603. DOI: 10.3971/j.issn.1000-8578.2013.06.023

乳腺癌临床病理指标以及分子分型对TEC新辅助化疗病理完全缓解的预测价值

详细信息
    作者简介:

    李小龙(1985-),男,硕士在读,主要从事乳腺癌治疗、乳癌术后乳房I期重建的研究

    通讯作者:

    涂刚,E-mail:tugang68@126.com

  • 中图分类号: R737.9

Predictive Values of Clinicopathological Parameters and Molecular Typing for Pathological Complete Response (pCR) in Breast Cancer Neoadjuvant Chemotherapy by TEC

  • 摘要: 目的 本研究旨在探讨乳腺癌临床病理指标以及乳腺癌分子分型对多西他赛联合表柔比星、环磷酰胺(TEC)的 新辅助化疗后病理完全缓解率(pathological complete response pCR)的预测价值。方法 对 214例经4周期TEC新辅助化疗的乳腺癌患者的临床病理资料进行回顾性分析;免疫组织化学检测经核心针穿刺 的癌组织雌激素受体(ER)、孕激素受体(PR)、人类表皮生长因子受体-2(HER2)、Ki67、p53表达情况,原位基 因免疫荧光杂交(FISH)检测HER2有无过表达;根据ER、PR、HER2、Ki67的表达情况将乳腺癌分为4种分子分型: LuminalA、 LuminalB、HER2过表达型和三阴性乳腺癌。分析不同的临床病理指标、不同分子分型与pCR的相关性。结果 4周期TEC新辅助化疗后pCR率为14.0%(30/214);单因素分析:ER、PR、Ki67、乳腺癌分子分型与pCR均具有显 著相关性(P<0.05);乳腺癌分子分型各组间显示pCR率不同:LuminalA<LuminalB<HER2过表达型<三阴性乳腺癌 ;多因素分析:与pCR具有显著相关性的分类变量为ER (OR=0.311,95%CI:0.136~0.712;P=0.006)和Ki67 (OR=2.788,95%CI:1.061~7.327;P=0.038)。结论 ER、PR、Ki67以及乳腺癌分子分型可能是TEC新辅助化疗后乳腺癌pCR的预测指标。

     

    Abstract: Objective To investigate whether clinical and pathological factors and molecularsubtypes of breast cancer was able to predict pathological complete response (pCR) after neoadjuvant chemotherapy using docetaxel plus epirubicin, cytoxan (TEC-NAC). Methods Two hundred and fourteen patients who underwent 4 cycles of TEC-NAC were retrospectively studied. In Core-needle biopsy specimens, estrogen receptor(ER), progesterone receptor(PR), human epidermal growth factor receptor-2(HER2), Ki67 and p53 were detected by immunohistochemical assay, and HER2 was also detected by Fluorescence In Situ Hybridization(FISH). Breast cancer was divided into 4 molecular subtypes of LuminalA, LuminalB, HER2 overexpression and triple negative breast cancer based on the expression levels of ER, PR, HER2 and Ki67.The correlation between these Factors and pCR was analyzed. Results Among all 214 cases, pCR was 14.0% (30/214) after 4 cycles of TEC-NAC. In the univariate analysis, the correlation between expressions of ER, PR, Ki67 and molecular subtypes of breast cancer and pCR were significant (P<0.05 all). pCR rates were LuminalA CI: 0.136 to 0.712; P=0.006) and Ki67 (OR=2.788,95% CI:1.061 to 7.327;P=0.038). Conclusion ER, PR negative expression, Ki67-positive and molecular subtypes of breast cancer might be the predictors of pCR.

     

  • [1] Kong X, Moran MS, Zhang N, et al. Meta-analysis confirms achieving pathological complete response after neoadjuvant chemotherapy predicts favourable prognosis for breast cancer patients[J].Eur J Cancer,2011, 47(14):2084-90.
    [2] Mazouni C, Peintinger F, Wan-Kau S, et al. Residual ductal carcinoma in situ in patients with complete eradication of invasive breast cancer after neoadjuvant chemotherapy does not adversely affect patient outcome [J]. J Clin Oncol,2007,25(19):2650-5.
    [3] Edge SB, Byrd DR, Compton CC, et al. AJCC Cancer Staging Manual[M].7th ed.New York: Springer, 2010:347-76.
    [4] Hammond ME, Hayes DF, Dowsett M,et al. American Society of Clinical Oncology/College of American Pathologists guideline recommendations for immunohistochemical testing of estrogen and progesterone receptors in breast cancer [J]. J Clin Oncol,2010,28(16):2784-95.
    [5] Fasching PA, Heusinger K, Haeberle L, et al. Ki67, chemotherapy response, and prognosis in breast cancer patients receiving neoadjuvant treatment[J].BMC Cancer,2011,11:486.
    [6] Wolff AC, Hammond ME, Schwartz JN, et al. American society of clinical oncology/college of american pathologists guideline recommendations for human epidermal growth factor receptor 2 testing in breast cancer[J].Arch Pathol Lab Med,2007,131(1):18-43.
    [7] Shao ZM.Chinese anti-cancer association guideline for breast cancer (2011 edition) [J].Zhongguo Ai Zheng Za Zhi,2011,21(5):367-417.[邵志敏.中国抗癌协会乳腺癌诊治指南与规范(2011版)[J].中国癌症杂 志,2011,21(5):367-417.]
    [8] Hugh J, Hanson J, Cheang  MC,et al. Breast cancer subtypes and response to docetaxel in node- positive breast cancer: use of an immunohistochemical definition in the BCIRG 001 trial[J]. J Clin Oncol, 2009,27(8): 1168-76.
    [9] Park S, Koo JS, Kim MS,et al. Characteristics and outcomes according to molecular subtypes of breast cancer as classified by a panel of four biomarkers using immunohistochemistry[J]. Breast,2012,21(1):50-7.
    [10] Liu QM,Cao YL,Wu XB,et al.Clinical value of molecular subtypes for breast cancer prognosis of dose dense docetaxel meoadjuvant chemotherapy[J]. Zhong Liu Fang Zhi Yan Jiu,2013,40(1):59-54.[ 刘秋明,曹亚丽,吴晓波,等.乳腺癌分子分型在多西他赛密集新辅助化疗疗效及预后中的预测价值[J].肿瘤防治 研究,2013,40(1):59-64.]
    [11] Guarneri V, Broglio K, Kau SW, et al. Prognostic value of pathologic complete response after primary chemotherapy in relation to hormone receptor status and other factors[J]. J Clin Oncol, 2006,24(7):1037-44.
    [12] Li X, Liu M, Zhang YJ, et al. Evaluation of ER, PgR, HER-2, Ki-67, cyclin D1, and nm23-H1 as predictors of pathological complete response to neoadjuvant chemotherapy for locally advanced breast cancer[J]. Med Oncol, 2011,28 Suppl 1:S31-8.
    [13] Learn PA, Yeh IT, McNutt M, et al. Her 2/neu expression as a predictor of response  neoadjuvant docetaxel in atients with operable breast carcinoma[J]. Cancer,2005,103(11):2252-60.
    [14] Toi M, Nakamura S, Kuroi K,et al. Phase Ⅱ study of preoperative sequential FEC and docetaxel predicts of pathological response and disease free survival[J]. Breast Cancer Res Treat, 2008,110 (3):531-9.
    [15] Noske A, Loibl S, Darb-Esfahani S, et al. Comparison of different approaches for assessment of HER2 expression on protein and mRNA level: Prediction of chemotherapy response in the neoadjuvant GeparTrio trial (NCT00544765)[J].Breast Cancer Res Treat,2011,126(1):109-17.
    [16] Jones RL, Salter J, A'Hern R, et al. Relationship between oestrogen receptor status and proliferation in predicting response and long-term outcome to neoadjuvant chemotherapy for breast cancer [J]. Breast Cancer Res Treat, 2010,119(2):315-23.
    [17] Petit T, Wilt M, Velten M, et al. Comparative value of tumour grade, hormonal receptors, Ki-67, HER-2 and topoisomerase II alpha status as predictive markers in breast cancer patients treated with neoadjuvant anthracycline-based chemotherapy [J].Eur J Cancer , 2004,40(2):205-11.
    [18] Goldhirsch A, Wood WC, Coates AS, et al. Strategies for subtypes: Dealing with the diversity of breast cancer-Highlights of the St Gallen International Expert Consensus on the Primary Therapy of Early Breast Cancer [J]. Ann Oncol, 2011, 22(8):1736-47.
    [19] Perou CM, S rlie T, Eisen MB, et al. Molecular portraits of human breast tumours[J]. Nature,2000 ,406(6797):747-52.
    [20] Liedtke C, Mazouni C, Hess KR, et al. Response to neoadjuvant therapy and long-term survival in patients with triple-negative breast cancer[J].J Clin Oncol,2008,26(8):1275-81.
    [21] Wu J, Li S, Jia W, et al. Response and prognosis of taxanes and anthracyclines neoadjuvant chemotherapy in patients with triple-negative breast cancer[J].J Cancer Res Clin Oncol,2011,137 (10):1505-10.
    [22] Darb-Esfahani S, Loibl S, Muller BM, et al. Identication of biology based breast cancer types with distinct predictive and prognostic features: role of steroid hormone and HER2 receptor expression in patients treated with neoadjuvant anthracycline/taxane-based chemotherapy[J].Breast Cancer Res, 2009,11(5):R69.
计量
  • 文章访问数:  1842
  • HTML全文浏览量:  21
  • PDF下载量:  361
  • 被引次数: 0
出版历程
  • 收稿日期:  2012-07-19
  • 修回日期:  2012-10-25
  • 刊出日期:  2013-06-24

目录

    /

    返回文章
    返回
    x 关闭 永久关闭