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HER2阳性乳腺癌新辅助治疗病理完全缓解预测因素分析

Predictive factors of pathological complete response in primary human epidermal growth factor receptor 2-positive breast cancer treated with trastuzumab-based neoadjuvant chemotherapy

摘要:

目的 探讨人类表皮生长因子受体2(HER2)阳性乳腺癌新辅助治疗病理完全缓解(pCR)的预测因素.方法 回顾性分析2007年9月至2014年12月北京大学第一医院乳腺疾病中心实施新辅助治疗的HER2阳性乳腺癌病例.101例患者符合纳入标准进入本研究,患者均为女性,年龄23 ~ 70岁,中位年龄53岁.新辅助治疗方案均为紫杉类+铂类联合曲妥珠单抗,疗程完毕接受乳腺癌根治性手术.pCR定义为乳腺原发病灶及腋窝淋巴结无浸润性肿瘤残留,总体pCR率为37.6% (38/101).采用x2检验或Fisher确切概率法进行单因素分析,采用Logistic回归进行多因素分析,探讨治疗前临床病理因素对pCR的预测价值.结果 单因素分析结果显示,肿瘤浸润淋巴细胞表达(x2=14.981,P=0.000)、激素受体状态(x2=9.513,P=0.002)及组织学分级(x2 =4.005,P=0.045)与pCR显著相关.多因素分析结果显示,肿瘤浸润淋巴细胞表达阳性(OR=4.74,95% CI:1.87 ~ 12.01,P=0.001)和激素受体状态阴性(OR=3.28,95% CI:1.31~8.20,P=0.011)是pCR的独立预测因素.结论 肿瘤浸润淋巴细胞表达阳性和激素受体状态阴性是HER2阳性乳腺癌新辅助治疗pCR的独立预测因素.

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abstracts:

Objective To investigate the predictive factors of pathological complete response (pCR) in primary human epidermal growth factor receptor 2 (HER2)-positive breast cancer treated with trastuzumab-based neoadjuvant chemotherapy (NAC).Methods Totally 101 patients of primary HER2-positive breast cancer treated with trastuzumab-based NAC and subsequent curative surgical therapy in the Breast Disease Center of Peking University First Hospital from September 2007 to December 2014 were retrospectively reviewed.All patients were female with a median age of 53 (range 23 to 70) years.All patients received a taxanes-and carboplatin-containing chemotherapy, and trastuzumab was administered concurrendy.A pCR, defined as the absence of invasive tumor cells in the breast and axillary lymph nodes, was achieved in 37.6% of patients (38/101).For analysis of the associations between clinicopathological factors and pCR, the x2 test or Fisher's exact test was used for univariate analysis, and multivariate Logistic regression analysis was performed to estimate OR and 95% CI.Results Tumor-infiltrating lymphocytes (x2 =14.981, P =0.000), hormone receptor (HR) status (x2 =9.513, P =0.002), and tumor grade (x2 =4.005, P =0.045) were significantly associated with pCR in univariate analysis.Tumor-infiltrating lymphocytes positive (OR =4.74, 95% CI: 1.87 to 12.01, P =0.001) and HR-negative (OR =3.28, 95% CI: 1.31 to 8.20, P =0.011) were independent predictive factors of pCR in multivariate analysis.Conclusion Tumor-infiltrating lymphocytes-positive and HR-negative were independent predictive factors of pCR in primary HER2-positive breast cancer treated with trastuzumab-based NAC.

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作者: 刘世伟 [1] 徐玲 [1] 张虹 [2] 张爽 [2] 李挺 [2] 段学宁 [1] 刘荫华 [1]
第一作者: 刘世伟
期刊: 《中华外科杂志》2016年54卷2期 94-98页 MEDLINEISTICPKUCSCD
栏目名称: 论著
DOI: 10.3760/cma.j.issn.0529-5815.2016.02.004
发布时间: 2016-03-15
基金项目:
Research Grants from the Clinical Features Research of Capital Capital Medical Development Fund Project Beijing Municipal Science and Technology Commission 首都临床特色应用研究资助项目 首都医学发展科研基金资助项目 北京市科委科技计划资助项目
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