摘要
目的探讨激素受体状态在不同临床特征的亚组中对Her-2阳性乳腺癌新辅助化疗效果的影响。方法收集北京儿童医院顺义妇儿医院2011年1月至2018年12月141例接受新辅助化疗的Her-2阳性乳腺癌患者进行回顾性分析,根据年龄、肿瘤T分期、淋巴结(LN)情况、Ki-67指数、是否抗Her-2治疗将患者分成不同的亚组,对每个亚组中两种激素受体状态的病理完全缓解(pCR)与非病理完全缓解(non-pCR)的构成比进行比较。统计学采用两个独立样本的Pearson χ^(2)检验或Fisher确切概率法。结果入组141例Her-2阳性乳腺癌患者新辅助化疗后均可行疗效评价,总体pCR率为44.0%(62/141)。总体上,HR阴性的患者较HR阳性患者更容易在新辅助化疗后达到pCR(P=0.011)。亚组分析中,在年龄≤50岁、肿瘤T分期≤2 cm、LN阴性、Ki-67≤30%、应用抗Her-2治疗的亚组,HR阴性的患者较HR阳性患者更容易在新辅助化疗后达到pCR(P=0.005、0.032、0.045、0.017、0.003)。结论对于Her-2阳性乳腺癌,HR状态是影响新辅助化疗效果的重要因素,HR阴性的患者较HR阳性患者更容易在新辅助化疗后达到pCR,尤其是在肿瘤负荷低、同时应用抗Her-2治疗的年轻患者中,这种优势更明显。
Objective To investigate the effect of hormone receptor(HR)status on the efficacy of neoadjuvant chemotherapy for Her-2-positive breast cancer in subgroups with different clinical characteristics.Methods A total of 141 patients with Her-2-positive breast cancer undergoing neoadjuvant chemotherapy in Shunyi Women’s and Children’s Hospital of Beijing Children’s Hospital from January 2011 to December 2018 were retrospectively analyzed.They were divided into different subgroups according to age,tumor T-stage,lymph node(LN)status,Ki-67 index,and whether they were receiving anti-Her-2 treatment.The composition ratios of pathological complete remission(pCR)and non-pathological complete remission(non-pCR)of two HR status were compared among each subgroup.Statistics were performed by Pearson’sχ^(2) test or Fisher’s precision probability test for two independent samples.Results All 141 patients with Her-2-positive breast cancer undergoing neoadjuvant chemotherapy enrolled in this study were feasibly evaluated for efficacy,with an overall pCR rate of 44.0%(62/141).Overall,HR-negative patients were more likely to achieve pCR after neoadjuvant chemotherapy than HR-positive patients(P=0.011).Through subgroup analysis,it was found that HR-negative patients were more likely to achieve pCR after neoadjuvant chemotherapy than HR-positive patients in the subgroup of patients aged≤50 years,with tumor T-stage≤2 cm,LN-negative,Ki-67≤30%,and on anti-Her-2 treatment(P=0.005,0.032,0.045,0.017,0.003).Conclusion For Her-2-positive breast cancer,HR status is an important factor affecting the efficacy of neoadjuvant chemotherapy,and HR-negative patients are more likely to achieve pCR after neoadjuvant chemotherapy than HR-positive patients,especially in younger patients with low tumor load and on anti-Her-2 treatment.
作者
杨青中
吕艳丽
穆为民
李毅
YANG Qingzhong;LV Yanli;MU Weimin;LI Yi(Breast Center,Shunyi Maternal and Child Healthcare Hospital of Beijing,Shunyi Women’s and Children’s Hospital of Beijing Children’s Hospital,Beijing 101300,China)
出处
《中国医药科学》
2022年第4期15-19,共5页
China Medicine And Pharmacy
关键词
Her-2阳性乳腺癌
新辅助化疗
病理完全缓解
激素受体
Her-2-positive breast cancer
Neoadjuvant chemotherapy
Pathological complete remission
Hormone receptor
