局部晚期乳腺癌临床病理特征与新辅助化疗效果和预后的关系

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Abstract Objective To investigate the relationship between clinical and pathological characteristics and the efficacy and prognosis of neoadjuvant chemotherapy (NAC) in locally advanced breast cancer. Methods The clinical and pathological data of 181 breast cancer patients receiving NAC in Shiyan Taihe Hospital, Hubei Province from January 2012 to December 2015 were analyzed. According to the clinical effect, they were divided into clinically effective group (149 cases) and clinically ineffective group (32 cases), and then into pathologically effective group (70 cases) and pathologically ineffective group (111 cases) according to the pathological effect. Patients with different clinical effects and different pathological effects were compared for clinical disease management index data. Multivariate logistic regression was used to analyze the influencing factors of clinical and pathological outcomes of NAC. Survival curves were used to analyze the prognosis of patients with different molecular types and different hormone receptor status after NAC. Results The clinical response rate of 181 patients was 82.3%, and the clinical complete response rate was 20.4%. The pathologic response rate was 38.7%, and the pathologic complete response rate was 14.4%. There was statistically significant difference in molecular typing between the clinically effective group and the clinically ineffective group (P ＜ 0.05). The difference of molecular typing between pathologically effective group and pathologically ineffective group was statistically significant (P ＜ 0.05). The proportion of progesterone receptor (PR) negative in the clinically effective group was lower than that in the clinically ineffective group, the proportion of Ki-67 positive and the proportion of p53 negative were higher than that in the clinically ineffective group, the difference was statistically significant (P ＜ 0.05). The percentages of estrogen receptor (ER) negative, PR negative and Ki-67 positive in pathologically effective group were all higher than those in pathologically ineffective group, with statistical significance (P ＜ 0.05). Multivariate analysis showed that Ki-67 positive and p53 negative were clinically effective independent risk factors for NAC (OR ＞ 1, P ＜ 0.05), and PR negative and triple negative breast cancer (TNBC) were its protective factors for NAC (OR ＜ 1, P ＜ 0.05). Ki-67 positive was a pathologically effective independent risk factor (OR ＞ 1, P ＜ 0.05), while PR negative and TNBC were its protective factors for NAC (OR ＜ 1, P ＜ 0.05). Survival analysis showed that the overall survival time of patients with different molecular subtypes after NAC treatment was statistically significant (P ＜ 0.05). After NAC treatment, the overall survival time of patients with Luminal type was longer than that of patients with non-luminal type, and the difference was statistically significant (P ＜ 0.05). Conclusion There are many factors affecting the efficacy of NAC, and the prognosis of breast cancer varies with different molecular types.

Key words： Locally advanced breast cancer Neoadjuvant chemotherapy Molecular typing Efficacy Prognosis

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	AI Yongbiao HUANG Jun ZHANG Shuming LI Wenfang ZHANG Danfeng

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AI Yongbiao HUANG Jun ZHANG Shuming LI Wenfang ZHANG Danfeng. Analysis of relationship between clinical and pathological characteristics and efficacy and prognosis of neoadjuvant chemotherapy in locally advanced breast cancer[J]. 中国医药导报, 2021, 18(20): 86-90.

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https://www.yiyaodaobao.com.cn/EN/ OR https://www.yiyaodaobao.com.cn/EN/Y2021/V18/I20/86

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