摘要
目的探讨21基因复发风险评分(recurrence score,RS)对早期激素受体阳性、淋巴结阴性乳腺癌术后辅助治疗的决策导向作用。方法收集自2013年6月至2016年12月在西安交通大学第一附属医院行手术治疗,且术后行21基因检测评分的早期激素受体阳性、淋巴结阴性的乳腺癌患者110例,按21基因复发风险评分标准分为低危组、中危组和高危组,比较其行21基因检测前后治疗决策的改变。结果在行21基因复发风险评分前,共有61例(55%)患者推荐使用辅助化疗+辅助内分泌治疗。行21基因复发风险评分后,32例(29%)患者改为行单纯辅助内分泌治疗(McNemar's test,P<0.001)。其中低危组和中危组行21基因复发风险评分后,分别有24例(39%)和8例(20%)患者由辅助化疗联合内分泌治疗改为仅行术后辅助内分泌治疗(McNemar's test,P<0.001;P=0.008)。结论对于早期激素受体阳性、淋巴结阴性乳腺癌患者,行21基因复发风险评分可以显著避免低危组和中危组患者的过度术后辅助化疗,降低术后化疗率,减少患者化疗副反应。
Objective To investigate the postoperative adjuvant therapeutic decision-oriented role of 21-gene recurrence score(RS) in hormone receptor positive and lymph node negative early stage breast cancer. Methods Our study included 110 hormone receptor positive and lymph node negative early stage breast cancer patients who were tested for 21-gene RS and underwent surgical treatment between June 2013 and December 2016 at The First Affiliated Hospital of Xi’an Jiaotong University. According to the 21-gene RS, the included patients were divided into low-, intermediate-and high-risk groups. We compared the changes of treatment decisions before and after the 21-gene test. Results Before taking the 21-gene test, 61 patients(55%) were recommended both adjuvant chemotherapy and endocrine therapy. However, after taking the test, 32 patients(29%) were treated with only adjuvant endocrine therapy(McNemar’s test, P<0.001). Among them, in the low-risk and intermediate risk groups, 24 patients(39%) and 8 patients(20%) were respectively treated with only adjuvant endocrine therapy instead of adjuvant chemotherapy combined with endocrine therapy(McNemar’s test, P<0.001;P=0.008) after taking the 21-gene test. Conclusion For patients with hormone receptor positive and lymph node negative early stage breast cancer, taking the 21-gene test can significantly avoid excessive postoperative adjuvant chemotherapy in both low-and intermediate-risk groups. Moreover, it can reduce the postoperative chemotherapy rate and lessen the side effects of chemotherapy.
作者
朱丽喆
马楠
巩凯丽
汪蕾
王彬
何建军
任予
闫宇
ZHU Li-zhe;MA Nan;GONG Kai-li;WANG Lei;WANG Bin;HE Jian-jun;REN Yu;YAN Yu(Department of Breast Surgery,The First Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710061;Xi'an Jiaotong University Health Science Center,Xi'an 710061;Department of Obstetrics and Gynecology,The First Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710061,China)
出处
《西安交通大学学报（医学版）》
CAS
CSCD
北大核心
2019年第6期962-966,1006,共6页
Journal of Xi’an Jiaotong University（Medical Sciences）
基金
国家自然科学基金青年科学基金资助项目(No.81702633)~~
关键词
21基因复发风险评分
早期乳腺癌
激素受体阳性
辅助化疗
治疗决策
21-gene recurrence score
early-stage breast cancer
hormone receptor positive
adjuvant chemotherapy
treatment decision
