不同分子分型乳腺癌与新辅助化疗疗效及预后的关系

发布时间：2018-03-01 21:00

本文关键词： 乳腺癌分子分型新辅助化疗预后　出处：《新疆医科大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:探讨乳腺癌不同分子分型与新辅助化疗疗效及预后的相关性。方法:对新疆医科大学附属肿瘤医院2009年1月至2015年9月间初治的344例新辅助化疗乳腺癌患者进行回顾性分析,将乳腺癌患者通过免疫组化检测雌激素受体(ER)、孕激素受体(PR)、人表皮生长因子受体-2(HER-2)的表达情况,分为Luminal A、Luminal B、HER-2过表达和Basal-like四类分子亚型,并通过各分子分型对新辅助化疗的病理反应性分析不同分子亚型乳腺癌与新辅助化疗疗效及预后的相关性。结果:Luminal A型54例,LuminalB型149例,Her-2过表达型59例,三阴型82例,其中Luminal A型、LuminalB型、Her-2过表达型、Basal-Like型的MP5(pCR)率分别为3.5%,1.8%,1.3%、5.3%;Her-2过表达型及Basal-Like型乳腺癌化疗病理显效率高于Luminal亚型。Luminal A亚型、LuminalB型、Her-2过表达型、Basal-Like型的5年DFS和OS分别为92.6%、89.3%、71.2%、75.6%,和100%、98.0%、89.8%、93.9%,差异具有统计学意义(P=0.000,P=0.016);结论:相比于Luminal A型,Basal-like型和Her-2过表达亚型的新辅助化疗病理显效率高,但预后较差,而Luminal亚型乳腺癌的预后明显好于Her-2过表达型、Basal-Like型。Basa1-1ike亚型和Her-2过表达亚型的化疗敏感性优于Luminal亚型,能获得更好的pCR率。乳腺癌分子分型能作为乳腺癌新辅助化疗疗效的有效预测因子。
[Abstract]:Objective: to investigate the correlation between different molecular classification of breast cancer and the curative effect and prognosis of neoadjuvant chemotherapy. Methods: 344 cases of neoadjuvant chemotherapy breast cancer were treated from January 2009 to September 2015 in the affiliated Cancer Hospital of Xinjiang Medical University. For retrospective analysis, The expression of estrogen receptor (ERG), progesterone receptor (PRN) and human epidermal growth factor receptor (EGF) HER-2 were detected by immunohistochemistry in patients with breast cancer. The relationship between different molecular subtypes of breast cancer and the curative effect and prognosis of neoadjuvant chemotherapy was analyzed through the pathological reactivity of different molecular subtypes of neoadjuvant chemotherapy. Results 59 cases of Her-2 overexpression and 82 cases of triple negative type were found in 149 cases of LuminalB type. The rate of MP5pCRs of Luminal A and Her-2 overexpression type Basal-Like type was 3.55.51 and 1.38, respectively, and the pathological efficiency of Basal-Like breast cancer was higher than that of Luminal subtype. Luminal A subtype, LuminalB Her-2 over-expression type and Basal-Like type. The 5 year DFS and OS of Basal-Like type were 92.689.31.2m75.65.6, and 10098.00.89. 889, 93.9, respectively. The difference was significant. Conclusion: compared with Luminal A type and Her-2 overexpression subtype, neoadjuvant chemotherapeutic effect of neo-adjuvant chemotherapy is higher than that of neo-adjuvant chemotherapy. However, the prognosis of Luminal subtype was significantly better than that of Her-2 overexpression type Basal-Like subtype and Her-2 overexpression subtype. The chemosensitivity of Luminal subtype was better than that of Luminal subtype. The molecular classification of breast cancer can be used as an effective predictor of neoadjuvant chemotherapy in breast cancer.
【学位授予单位】：新疆医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R737.9

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