乳腺癌术前化疗疗效及其对分子标记物的影响

目的]通过研究乳腺幅术前化疗疗效及其对分子标记物的影响，进一步评价新辅助化疗的临床价值：方法]对100例经窄芯针穿刺收材病理确诊的乳腺癌患者，给于术前化疗（新辅助化疗）方案2周期，继之行根治术，术后免疫组化测分子标记物ER、PR和c—erb B-2，并与化疗前的检查结果比对．结果]经新辅助化疗后，乳腺癌原发灶明显缩小，11％（11例）达到完全缓解（CR）；腋窝淋巴结阳性率下降，21．6％（8／37）达到完全缓解（CR）；ER、PR和c-erb B-2的表达与新辅助化疗前不相符，不符合率分别为46％、37％和12％、结论]新辅助化疗对降低病期、争取保乳机会、筛选敏感的化疗药物大有益处．但因其影响了术后ER，PR和c-erbB-2等分子标记物结果，不利于医生制定放疗、内分泌治疗及基因治疗等方案，有待于进一步研究解决此矛盾。

Effect of Pre-operative Chemotherapy and Its Influence on Molecular Markers in Breast Cancer

Purpose]To investigate the response of neoadjuvant chemotherapy for breast cancer,and its influence on molecular markers.Methods]One hundred breast cancer patients pathologically proved,received radical operation after 2 cycles of neoadjuvant chemotherapy.Immunohistochemical results of ER,PR and c-erbB-2 before chemotherapy and after operation were compared.Results] After neoadjuvant chemotherapy,the primary cancer reduced significantly with 11% of complete response(CR).The rate of positive axillary lymph node decreased with 21.6% of CR.Expression of ER(46%),PR(37%)and c-erbB-2(12%)after operation were quite discrepancy with those before therapy.Conclusion] Neoadjuvant chemotherapy may be beneficial to decrease the clinical stage,to get chance for breast conservation operation and to select sensitive agents for breast cancer,but it also influence on post-operation molecular markers,and interfere with treatment plan making.