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原发性乳腺癌分子分型与新辅助化疗疗效及预后的相关性

吕民豪, 秦丽, 李军涛, 郭旭辉, 刘法文, 崔树德, 张恒伟

吕民豪, 秦丽, 李军涛, 郭旭辉, 刘法文, 崔树德, 张恒伟. 原发性乳腺癌分子分型与新辅助化疗疗效及预后的相关性[J]. 肿瘤防治研究, 2015, 42(08): 782-788. DOI: 10.3971/j.issn.1000-8578.2015.08.007
引用本文: 吕民豪, 秦丽, 李军涛, 郭旭辉, 刘法文, 崔树德, 张恒伟. 原发性乳腺癌分子分型与新辅助化疗疗效及预后的相关性[J]. 肿瘤防治研究, 2015, 42(08): 782-788. DOI: 10.3971/j.issn.1000-8578.2015.08.007
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LV Minhao, QIN Li, LI Juntao, GUO Xuhui, LIU Fawen, CUI Shude, ZHANG Hengwei. 原发性乳腺癌分子分型与新辅助化疗疗效及预后的相关性[J]. Cancer Research on Prevention and Treatment, 2015, 42(08): 782-788. DOI: 10.3971/j.issn.1000-8578.2015.08.007
Citation: LV Minhao, QIN Li, LI Juntao, GUO Xuhui, LIU Fawen, CUI Shude, ZHANG Hengwei. 原发性乳腺癌分子分型与新辅助化疗疗效及预后的相关性[J]. Cancer Research on Prevention and Treatment, 2015, 42(08): 782-788. DOI: 10.3971/j.issn.1000-8578.2015.08.007
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原发性乳腺癌分子分型与新辅助化疗疗效及预后的相关性

  • 450008 郑州，河南省肿瘤医院 郑州大学附属肿瘤医院乳腺病中心

详细信息
    作者简介:

    吕民豪（1987-），男，硕士，主治医师，主要从事乳腺癌的综合治疗

    通讯作者:

    张恒伟，E-mail: hengwei@medmail.com.cn

  • 中图分类号: R737.9

原发性乳腺癌分子分型与新辅助化疗疗效及预后的相关性

  • Breast Diseases Center, He'nan Cancer Hospital & Affiliated Cancer Hospital, Zhengzhou University, Zhengzhou 450008, China

摘要

    摘要
  • 摘要: 目的 探讨原发性乳腺癌分子分型与新辅助化疗疗效及预后之间的相关性。方法 回顾性分析河南省肿瘤医院收治的204例接受新辅助化疗患者的临床病理资料，分为Luminal A、LuminalB、HER2阳性和三阴乳腺癌4种亚型，分析乳腺癌分子分型对新辅助化疗疗效及预后的预测作用。结果 204例患者中，40例（19.6％）为Luminal A亚型，46例（22.5％）为Luminal B亚型，36例（17.6％）为HER2阳性亚型，82例（40.2％）为三阴乳腺癌亚型。HER2阳性（22.2%）及三阴乳腺癌亚型（22.4%）的病理完全缓解（pCR）率明显高于Luminal A亚型（2.5％）及Luminal B亚型（6.5％），差异有统计学意义（P=0.03）。与Luminal亚型相比，HER2阳性及三阴乳腺癌亚型具有更差的无病生存期（DFS）（P=0.001）和OS（P=0.002）；剔除获得pCR的患者，单独评价存在肿瘤残留的患者，我们发现HER2阳性及三阴乳腺癌亚型比Luminal亚型具有更差的DFS（P<0.001）和OS（P<0.001）。获得pCR的乳腺癌患者的5年DFS和总生存期（OS）均明显高于化疗后仍有癌残留的患者（P=0.002, P=0.012）。结论 相对于Luminal亚型，HER2 阳性和三阴乳腺癌亚型对新辅助化疗更为敏感，更易达到pCR；但是HER2阳性和三阴乳腺癌亚型预后反而更差。

     

    Abstract: Objective To explore the relationship of molecular subtypes with the responses and outcome of primary breast cancer patients treated with neoadjuvant chemotherapy. Methods We included 204 patients with primary breast cancer treated with neoadjuvant chemotherapy in He'nan Tumor Hospital in this retrospective study. The patients were classified into 4 subtypes: Luminal A, Luminal B, HER2 positive and triple-negative. The predictive role of molecular subtype in the response and outcome of breast cancer patients treated with neoadjuvant chemotherapy were analyzed. Results Among all 204 patients, 40(19.6%) patients were Luminal A subtype, 46(22.5%) were Luminal B subtype, 36 (17.6%) were HER2 positive subtype and 82 (40.2%) were triple-negative subtype. The pCR rates of HER2 positive(22.2%) and triplenegative(24.4%) subtypes were higher than those of Luminal A(2.5%) and Luminal B(6.5%), with significant difference(P=0.03). Despite initial chemosensitivity, the patients with HER2 positive and triple-negative subtypes had worse disease-free survival(DFS)(P=0.001) and overall survival(OS)(P= 0.002) than those with Luminal subtypes in the whole population, and especially worse in patients with residual disease after neoadjuvant chemotherapy with decreased DFS(P<0.001) and OS(P<0.001). The 5-year DFS and OS of patients who achieved pathological complete response(pCR) were significantly higher than those of patients with residual disease after chemotherapy(P=0.002, P=0.012, respectively). Conclusion We have found that breast cancer patients with HER2 positive and triple-negative subtypes have higher sensitivity to neoadjuvant chemotherapy and with higher rates of pCR but worse prognosis than those with Luminal subtypes.

     

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出版历程
  • 收稿日期:  2014-09-08
  • 修回日期:  2014-10-13
  • 刊出日期:  2015-08-24

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