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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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  • [1] Miller E, Lee HJ, Lulla A, et al. Current treatment of early breast cancer: adjuvant and neoadjuvant therapy[J]. F1000Res, 2014, 3: 198.
    [2] Angelucci D, Tinari N, Grassadonia A, et al. Long-term outcome of neoadjuvant systemic therapy for locally advanced breast cancer in routine clinical practice[J]. J Cancer Res Clin Oncol, 20 13, 139(2): 269-80.
    [3] Rastogi P, Anderson SJ, Bear HD, et al. Preoperative chemotherapy: updates of National Surgical Adjuvant Breast and Bowel Project Protocols B-18 and B-27[J]. J Clin Oncol, 2008, 26(5): 778-85.
    [4] van der Hage JA, van de Velde CJ, Julien JP, et al. Preoperative chemotherapy in primary operable breast cancer: results from the European Organization for Research and Treatment of Cancer trial 10 902[J]. J Clin Oncol, 2001, 19(22): 4224-37.
    [5] Kim SI, Sohn J, Koo JS, et al. Molecular subtypes and tumor response to neoadjuvant chemotherapy in patients with locally advanced breast cancer[J]. Oncology, 2010, 79(5-6): 324-30.
    [6] Carey LA, Perou CM, Livasy CA, et al. Race, breast cancer subtypes, and survival in the Carolina Breast Cancer Study[J]. JAMA, 2006, 295(21): 2492-502.
    [7] Hugh J, Hanson J, Cheang MC, et al. Breast cancer subtypes and response to docetaxel in node-positive breast cancer: use of animmunohistochemical definition in the BCIRG 001 trial[J]. J Clin Oncol, 2009, 27(8): 1168-76.
    [8] Ortiz AP, Frías O, Pérez J, et al. Breast cancer molecular subtypes and survival in a hospital-based sample in Puerto Rico [J]. Cancer Med, 2013, 2(3): 343-50.
    [9] Cheang MC, Voduc D, Bajdik C, et al. Basal-like breast cancer defined by five biomarkers has superior prognostic value than triple-negative phenotype[J]. Clin Cancer Res, 2008, 14 (5):1368-76.
    [10] Livasy CA, Karaca G, Nanda R, et al. Phenotypic evaluation of the basal-like subtype of invasive breast carcinoma[J]. Mod Pathol, 20 06, 19(2): 264-71.
    [11] Carey LA, Dees EC, Sawyer L, et al. The triple negative paradox: primary tumor chemosensitivity of breast cancer subtypes[J]. Clin Cancer Res, 2007, 13(8): 2329-34.
    [12] James K, Eisenhauer E, Christian M, et al. Measuring response in solid tumors: unidimensional versus bidimensional measurement[J]. J Natl Cancer Inst, 1999, 91(6): 523-8.
    [13] Huober J, von Minckwitz G, Denkert C, et al. Effect of neoadjuvant anthracycline-taxane-based chemotherapy in different biological breast cancer phenotypes: overall results from the GeparTrio study[J]. Breast Cancer Res Treat, 2010, 124(1): 133-40.
    [14] Bhargava R, Beriwal S, Dabbs DJ, et al. Immunohistochemical surrogate markers of breast cancer molecular classes predicts response to neoadjuvant chemotherapy: A single institutional experience with 359 cases[J]. Cancer, 2010, 116(6): 1431-9.
    [15] Straver ME, Rutgers EJ, Rodenhuis S, et al. The relevance of breast cancer subtypes in the outcome of neoadjuvant chemotherapy[J]. Ann Surg Oncol, 2010, 17(9):2411-8.
    [16] Parker JS, Mullins M, Cheang MC, et al. Supervised risk predictor of breast cancer based on intrinsic subtypes[J]. J Clin Oncol, 20 09, 27(8): 1160-7.
    [17] Rodenhuis S, Mandjes IA, Wesseling J, et al. A simple system for grading the response of breast cancer to neoadjuvant chemotherapy[J]. Ann Oncol, 2010, 21(3): 481-7.
    [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 2011[J]. Ann Oncol, 2011, 22(8): 17 36-1747.
    [19] Straver ME, Rutgers EJ, Rodenhuis S, et al. The Relevance of breast Cancer subtypes in the outcome of neoadjuvant chemotherapy[J]. Ann Surg Oncol, 2010, 17(9): 2411-8.
    [20] Kümler I , Tuxen MK, Nielsen DL. A systematic review of dual targeting in HER2-positive breast cancer[J]. Cancer Treat Rev, 20 14, 40(2): 259-70.
    [21] Prat A, Cruz C, Hoadley KA, et al. Molecular features of the basallike breast cancer subtype based on BRCA1 mutation status[J]. Breast Cancer Res Treat, 2014, 147(1): 185-91.
    [22] Symmans WF, Peintinger F, Hatzis C, et al. Measurement of residual breast cancer burden to predict survival after neoadjuvant chemotherapy[J]. J Clin Oncol, 2007, 25(28): 4414-22.
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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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