新辅助化疗对中青年不同分子分型乳腺癌患者免疫标志物表达变化和预后的影响Effect of neoadjuvant chemotherapy on the expression of immune markers and prognosis in young and middle-aged patients with different molecular typing of breast cancer
王峰;丁琦;潘跃银;韩兴华;
摘要(Abstract):
目的分析新辅助化疗对中青年不同分子分型乳腺癌患者免疫标志物表达变化和预后的影响。方法选取2016年3月至2020年3月安徽省立医院收治的251例中青年乳腺癌患者为研究对象,按照乳腺癌分子分型,将入选患者分别纳入Luminal A型组(86例)、Luminal B型组(64例)、人表皮生长因子受体-2(human epidermal growth factor receptor-2,HER-2)过表达型组(43例)、三阴性组(58例),均行新辅助化疗联合乳腺癌改良根治术治疗。检测四组患者新辅助化疗前和乳腺癌改良根治术后免疫标志物表达变化,比较各组患者预后特点。结果 Luminal A型组、Luminal B型组、三阴性组患者术后病理组织免疫标志物表达阳性率与本组新辅助化疗前穿刺结果比较差异均无统计学意义(均P>0.05);HER-2过表达型组患者术后病理雌激素受体阳性、孕激素受体阳性≥20%占比均显著高于本组新辅助化疗前(均P<0.05),HER-2阳性占比显著低于本组新辅助化疗前(P<0.05)。HER-2过表达型组、三阴性组术后分别有31例、9例患者发生分子分型改变。Luminal A型组、Luminal B型组患者术后1年内局部复发率、远处转移率均显著低于HER-2过表达型组和三阴性组(均P<0.05),Luminal A型组、Luminal B型组和HER-2过表达型组患者1年生存率均显著高于三阴性组(均P<0.05);HER-2过表达型组和三阴性组中术后分子分型改变者术后1年内局部复发率、远处转移率均显著低于本组分子分型未改变者(均P<0.05),1年生存率均显著高于本组分子分型未改变者(均P<0.05)。结论新辅助化疗治疗Luminal A型、Luminal B型乳腺癌效果确切,且能够促进HER-2过表达型、三阴性乳腺癌亚型转变,有助于改善患者预后。
关键词(KeyWords): 新辅助化疗;乳腺癌;免疫标志物;预后
基金项目(Foundation):
作者(Authors): 王峰;丁琦;潘跃银;韩兴华;
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