The cardiotoxicity and long-term efficacy of different doses of epirubicin in the adjuvant treatment of breast cancer patients：A case control study

Abstract Objective： The aim of the study was to observe the cardiac toxicity caused by different doses of epirubicin in the adjuvant treatment of breast cancer and to evaluate the long-term efficacy. Methods： The 180 cases of breast cancer patients received epirubicin based adjuvant chemotherapy. The patients were randomly assigned to high-dosage group （90 rag/m^2）, medium-dosage group （70 mg/m^2） and low-dosage group （50 rag/m^2）, the primary endpoint was cardiac toxicity. The secondary outcomes were the 5-year overall survival （OS） and 5-year disease-free survival （DFS）. Results： During chemo- therapy, the clinical symptoms such as palpitation, dyspnea and paroxysmal nocturnal dyspnea occurred in 6 patients with the high-dosage group, 4 patients with the medium-dosage group and 3 patients with the low-dosage group. The number of patients who had changed in electrocardiogram （ECG） was 7, 5 and 4 in three groups, respectively. The echocardiographic showed each group had only one case with LVEF 〈 50%, there was no significantly difference （P 〉 0.05）. In the three groups, the 5-year DFS rates were 73.3% （44/60） in high-dose group, 53.3% （32/60） in medium-dose group and 41.6% （25/60） in low dose group. The 5-year OS rates were 85.0% （51/60）, 68.3% （41/60） and 58.3% （35/60） in three groups, respectively. The differences were statistically significant （P 〈 0.05）. Conclusion： The high-dose epirubicin in adjuvant chemotherapy with CEF （cyclophosphamide, epirubicin and fluorouracil） regimen could improve the 5-year OS rate and 5-year DFS rate on patients of breast cancer. The cardiotoxicity was mild-moderate and well tolerated.     

Effect of Neoadjuvant CAF Regimen on the Expression of BCSG1 in Breast Cancer

Objective： To evaluate the efficacy of neoadjuvant chemotherapy and explore a sensitive and objective way in the evaluation of neoadjuvant chemotherapy, the pathological changes and BCSG1 expression were studied by pathological and immunohistochemical method in breast cancer patients with CAF neoadjuvant chemotherapy （Cyclophosphamide, Adriamycin and Fluorouracil, CAF） and those without at the same period. Methods： Specimens were obtained from 34 breast cancer patients receiving neoadjuvant CAF regimen chemotherapy （CAF group） and 110 breast cancer patients not receiving neoadjuvant chemotherapy （control group）. The BCSG1 expression was detected by SP immunohistochemistry. Correlation between BCSG1 expression and pathological response to CAF neoadjuvant chemotherapy was analyzed. Results： Overall response rate to neoadjuvant chemotherapy was 79.4%. The strong cytoplasm expression of BCSG1 was significantly lower in CAF group than in control group （29.4% vs. 64.5%, P〈0.01）. In CAF group, the positive cytoplasm expression in partial response （PR） （grade Ⅱ） cases was significantly lower than that in no response （NR） （grade Ⅲ） cases （P=0.002）. Conclusion： Neoadjuvant chemotherapy of CAF regimen could decrease the nuclear expression of BSCG1 in breast cancer.     

延迟辅助化疗对乳腺癌患者生存期的影响(英文)

Objective: The proper time to commence adjuvant chemotherapy after primary surgery for breast cancer is unknown. It is usually prescribed within 2-3 months after definitive surgery. The aim of this retrospective study was to assess the impact of adjuvant chemotherapy (CT) delay beyond 3 weeks ( 21 days) in premenopausal patients with ER-absent tumors being treated for early stages breast cancer on overall survival (OS) and disease-free survival (DFS). Methods: This retrospective study was conducted through revision of medical records of premenopausal patients diagnosed with early stage Ⅰ-ⅢA breast cancer and ER-absent tumors who received adjuvant CT after definitive surgery at the Department of Clinical Oncology, Ain-Shams University Hospitals. Results: Between 2005 and 2008, 105 patients were retrospectively analyzed and included. Patients were divided into 2 groups: Group A including 48 patients who started adjuvant CT<21 days of surgery and group B which included 57 patients who had CT delay ≥ 21 days. Both groups were matched demographically. Comparisons of overall survival, and disease-free survival between group A and group B patients all favored group A. At 5-year the OS rates were 87% and 73% for groups A and B respectively (P=0.001), while DFS rates were 85% and 64% in groups A and B respectively (P=0.001). Analysis of other prognostic factors (age, T, N, grade, HER2 status, surgery type, CT type, local radiotherapy received) were analyzed. Only nodal status predicted for worse DFS (P=0.05) and OS (P=0.006). Conclusion: Delay in initiating adjuvant chemotherapy for early stage breast cancer patients with ER-absent tumors was associated with a decrease in both OS and DFS rates.     

术前支气管动脉灌注化疗在肺癌手术中的临床研究

Objective： How to improve the postoperative 5-year survival rate for lung cancer and to give more patients a chance of surgery have become research hotspots. The aim of this research is to evaluate the clinical and pathohistological responses and effects of preoperative bronchial artery infusion （BAI） chemotherapy in patients with locally advanced （stage Ⅲ） non-small cell lung cancer （NSCLC）. Methods： A total of 92 patients with locally advanced NSCLC were randomly divided into two groups. BAI group received BAI chemotherapy for 2 cycles before surgical resection. Surgery group received operation only. The complete resection rate and clinical response were compared between the two groups. Results： In the BAI group, the clinical response rate and the pathohistological response rate were 68.3% and 51.3%, respectively. The complete resection rate in the BAI group was 89.7%, which was significantly higher than that in the surgery group （72.5%） （P 〈 0.05）. The 1- and 2-year survival rate was 100.0% and 80.6% in the BAI group, and 94.1% and 60.0% in the surgery group. Conclusion： BAI neoadjuvant chemotherapy is safe and effective, which has a good clinical and pathohistological response. It might increase the complete resection rate of the tumor and improve the long term survival rate of stage Ⅲ NSCLC patients.     

TTC及FTC方案新辅助化疗治疗乳腺癌的疗效分析

Objective To investigate the efficacy of TTC and FTC regimens as neoadjuvant chemotherapy in breast cancer. Methods Collecting clinical data of 325 patients received neoadjuvant chemotherapy with TIC and FTC regimens from June 2004 to April 2008, among them 138 patients received neoadjuvant chemotherapy with TTC regimen in one group, and 187 patients received neoadjuvant chemotherapy with CTF regimen in the other group. The expression of Topo Ⅱ a in specimen of 325 patients before neoadjuvant chemotherapy were detected by immunohistochemical method. Results Among the 325 cases of neoadjuvant chemotherapy, the overall response rate (RR) was 87.7 % in TIC arm and 67.4 % in FTC arm (P=0.000), but in the group of Topo Ⅱ a(+) Her-2(-), the overall response rate (RR) was 87.8 % in TTC arm and 79.4 % in FTC arm (P=0.266), and in the groups of Topo Ⅱ a(-), there was statistical significance; the pathologic complete response rate (pCR) was 13.7 % in TIC ann and 11.2 % in CTF ann (P=0.491). Conclusion TIC regimen is superior to FTC regimen in the response rate of neoadjuvant chemotherapy, but patients with negative expression of Topo Ⅱ a may get more benefits from 9eoadjuvant taxane and anthracycline chemotherapy.     

TTC及FTC方案新辅助化疗治疗乳腺癌的疗效分析

Objective To investigate the efficacy of TTC and FTC regimens as neoadjuvant chemotherapy in breast cancer. Methods Collecting clinical data of 325 patients received neoadjuvant chemotherapy with TIC and FTC regimens from June 2004 to April 2008, among them 138 patients received neoadjuvant chemotherapy with TTC regimen in one group, and 187 patients received neoadjuvant chemotherapy with CTF regimen in the other group. The expression of Topo Ⅱ a in specimen of 325 patients before neoadjuvant chemotherapy were detected by immunohistochemical method. Results Among the 325 cases of neoadjuvant chemotherapy, the overall response rate (RR) was 87.7 % in TIC arm and 67.4 % in FTC arm (P=0.000), but in the group of Topo Ⅱ a(+) Her-2(-), the overall response rate (RR) was 87.8 % in TTC arm and 79.4 % in FTC arm (P=0.266), and in the groups of Topo Ⅱ a(-), there was statistical significance; the pathologic complete response rate (pCR) was 13.7 % in TIC ann and 11.2 % in CTF ann (P=0.491). Conclusion TIC regimen is superior to FTC regimen in the response rate of neoadjuvant chemotherapy, but patients with negative expression of Topo Ⅱ a may get more benefits from 9eoadjuvant taxane and anthracycline chemotherapy.     

TTC及FTC方案新辅助化疗治疗乳腺癌的疗效分析

Objective To investigate the efficacy of TTC and FTC regimens as neoadjuvant chemotherapy in breast cancer. Methods Collecting clinical data of 325 patients received neoadjuvant chemotherapy with TIC and FTC regimens from June 2004 to April 2008, among them 138 patients received neoadjuvant chemotherapy with TTC regimen in one group, and 187 patients received neoadjuvant chemotherapy with CTF regimen in the other group. The expression of Topo Ⅱ a in specimen of 325 patients before neoadjuvant chemotherapy were detected by immunohistochemical method. Results Among the 325 cases of neoadjuvant chemotherapy, the overall response rate (RR) was 87.7 % in TIC arm and 67.4 % in FTC arm (P=0.000), but in the group of Topo Ⅱ a(+) Her-2(-), the overall response rate (RR) was 87.8 % in TTC arm and 79.4 % in FTC arm (P=0.266), and in the groups of Topo Ⅱ a(-), there was statistical significance; the pathologic complete response rate (pCR) was 13.7 % in TIC ann and 11.2 % in CTF ann (P=0.491). Conclusion TIC regimen is superior to FTC regimen in the response rate of neoadjuvant chemotherapy, but patients with negative expression of Topo Ⅱ a may get more benefits from 9eoadjuvant taxane and anthracycline chemotherapy.     

TTC及FTC方案新辅助化疗治疗乳腺癌的疗效分析

Objective To investigate the efficacy of TTC and FTC regimens as neoadjuvant chemotherapy in breast cancer. Methods Collecting clinical data of 325 patients received neoadjuvant chemotherapy with TIC and FTC regimens from June 2004 to April 2008, among them 138 patients received neoadjuvant chemotherapy with TTC regimen in one group, and 187 patients received neoadjuvant chemotherapy with CTF regimen in the other group. The expression of Topo Ⅱ a in specimen of 325 patients before neoadjuvant chemotherapy were detected by immunohistochemical method. Results Among the 325 cases of neoadjuvant chemotherapy, the overall response rate (RR) was 87.7 % in TIC arm and 67.4 % in FTC arm (P=0.000), but in the group of Topo Ⅱ a(+) Her-2(-), the overall response rate (RR) was 87.8 % in TTC arm and 79.4 % in FTC arm (P=0.266), and in the groups of Topo Ⅱ a(-), there was statistical significance; the pathologic complete response rate (pCR) was 13.7 % in TIC ann and 11.2 % in CTF ann (P=0.491). Conclusion TIC regimen is superior to FTC regimen in the response rate of neoadjuvant chemotherapy, but patients with negative expression of Topo Ⅱ a may get more benefits from 9eoadjuvant taxane and anthracycline chemotherapy.     

TTC及FTC方案新辅助化疗治疗乳腺癌的疗效分析

Objective To investigate the efficacy of TTC and FTC regimens as neoadjuvant chemotherapy in breast cancer. Methods Collecting clinical data of 325 patients received neoadjuvant chemotherapy with TIC and FTC regimens from June 2004 to April 2008, among them 138 patients received neoadjuvant chemotherapy with TTC regimen in one group, and 187 patients received neoadjuvant chemotherapy with CTF regimen in the other group. The expression of Topo Ⅱ a in specimen of 325 patients before neoadjuvant chemotherapy were detected by immunohistochemical method. Results Among the 325 cases of neoadjuvant chemotherapy, the overall response rate (RR) was 87.7 % in TIC arm and 67.4 % in FTC arm (P=0.000), but in the group of Topo Ⅱ a(+) Her-2(-), the overall response rate (RR) was 87.8 % in TTC arm and 79.4 % in FTC arm (P=0.266), and in the groups of Topo Ⅱ a(-), there was statistical significance; the pathologic complete response rate (pCR) was 13.7 % in TIC ann and 11.2 % in CTF ann (P=0.491). Conclusion TIC regimen is superior to FTC regimen in the response rate of neoadjuvant chemotherapy, but patients with negative expression of Topo Ⅱ a may get more benefits from 9eoadjuvant taxane and anthracycline chemotherapy.     

TTC及FTC方案新辅助化疗治疗乳腺癌的疗效分析

Objective To investigate the efficacy of TTC and FTC regimens as neoadjuvant chemotherapy in breast cancer. Methods Collecting clinical data of 325 patients received neoadjuvant chemotherapy with TIC and FTC regimens from June 2004 to April 2008, among them 138 patients received neoadjuvant chemotherapy with TTC regimen in one group, and 187 patients received neoadjuvant chemotherapy with CTF regimen in the other group. The expression of Topo Ⅱ a in specimen of 325 patients before neoadjuvant chemotherapy were detected by immunohistochemical method. Results Among the 325 cases of neoadjuvant chemotherapy, the overall response rate (RR) was 87.7 % in TIC arm and 67.4 % in FTC arm (P=0.000), but in the group of Topo Ⅱ a(+) Her-2(-), the overall response rate (RR) was 87.8 % in TTC arm and 79.4 % in FTC arm (P=0.266), and in the groups of Topo Ⅱ a(-), there was statistical significance; the pathologic complete response rate (pCR) was 13.7 % in TIC ann and 11.2 % in CTF ann (P=0.491). Conclusion TIC regimen is superior to FTC regimen in the response rate of neoadjuvant chemotherapy, but patients with negative expression of Topo Ⅱ a may get more benefits from 9eoadjuvant taxane and anthracycline chemotherapy.     

Short-term Intensive Neoadjuvant Chemotherapy Improving 10-year Survival for Patients with Stage Ⅱ and Operable Stage Ⅲ Breast Cancer

Objective To evaluate the 10-year curative effects of short-term intensive neoadjuvant chemotherapy for operable breast cancer. Methods A total of 510 patients with stagell and operable stagelll breast cancer were divided into group A (preoperative neoadjuvant chemotherapy 251 cases) and group B (postoperative adjuvant chemotherapy 259 cases). The patients in group A received short -term and intensive neoadjuvant chemotherapy for 4 weeks followed by modified radical mastectomy two weeks after the chemotherapy. The postoperative adjuvant chemotherapy began within two weeks after surgery. The same chemotherapeutic regimen was used for both groups. Results For stage III in group A the 5-year overall survival rate (OS) and disease-free survival rate (DFS) were 59.2% and 54.9% respectively which were higher than those in group B (28.3% and 20.8% respectively,P<0.05). The 10-year OS and DFS were 78.1% and 73.5% respectively for stage II in group A which were higher than those in group B (68.4% and 60.7%,P< 0.05). The 10-year OS and DFS were 42.3% and 40.4% respectively for stage III in group A which were higher than those in group B (20.4% and 18.4% respectively,P<0.05). Conclusion The results showed that intensive neoadjuvant chemotherapy can improve the 10-year survival for patients with stage II and operable stage III breast cancer.     

可手术的乳腺癌术前化疗的远期效果

目的探讨术前化疗对可手术的乳腺癌的远期疗效。方法可手术的乳腺癌患者５３７例,分为两组：术前化疗组（Ａ组）２５３例;术后辅助化疗组（Ｂ组）２８４例。Ａ组术前联合化疗,每周一次共４次,休２周行根治性手术。两组患者术后两周内开始化疗、化疗方案和完成化疗周期相同。结果（１）Ⅲ期患者,Ａ组５年总生存率（ＯＳ）５９％,无病存活率（ＤＦＳ）５４．９％,均明显高于Ｂ组２８．３％和２０．８％（Ｐ＜０．０５）。（２）Ⅱ期患者,Ａ组８年ＯＳ８１．４％,ＤＦＳ７６．３％,均高于Ｂ组６７．４％和６２．９％（Ｐ＜０．０５）。Ⅲ期患者,Ａ组８年ＯＳ４６．９％,ＤＦＳ４０．６％,也高于Ｂ组２０．７％和１３．３％（Ｐ＜０．０５）。（３）Ａ组Ｔ３、Ｔ４和转移淋巴结数≥４个的患者,５年、８年生存率均高于Ｂ组（Ｐ＜０．０５）。结论可手术的Ⅲ期乳腺癌,术前化疗可提高患者５年、８年生存率,明显改善Ⅱ期患者的远期疗效。     

TAC方案在乳腺癌新辅助化疗中的临床疗效观察

目的：探讨TAC（多西他赛＋阿霉索＋环磷酰胺）方案在乳腺癌新辅助化疗中的临床疗效。方法：35例Ⅱb-Ⅲa乳腺癌患者术前应用TAC方案进行2—4周期新辅助化疗,观察其有效率,并中位随访2年观察无病生存率及总生存率。结果：新辅助化疗后临床完全缓解（CR）8例,部分缓解（PR）20例,稳定（SD）3例,总有效率88．57％。其2年无病生存率与对照组有显著差异（P〈0．05）,总生存率两组无差别（P〉0．05）。结论：应用TAC方案行新辅助化疗可有效提高乳腺癌患者临床缓解率,延长患者无病生存期。     

TP方案在三阴性乳腺癌新辅助化疗中的疗效及预后分析

目的:探讨TP方案在三阴性乳腺癌新辅助化疗中的疗效,分析新辅助化疗疗效对预后的影响。方法:收集2011年08月至2015年06月德州市第二人民医院乳腺科收治的三阴性乳腺癌患者98例,所有患者均排除远处转移,随机分为研究组50例(给予TP方案新辅助化疗)和对照组48例(给予TAC方案新辅助化疗),观察其疗效,并对患者进行随访,统计其3年的无病生存率及总生存率。结果:研究组总有效率为84.0%(42/50),完全缓解率为36.0%(18/50),对照组总有效率为77.1%(37/48),完全缓解率为14.6%(7/48),总有效率无统计学差异(P=0.837),完全缓解率有统计学差异(P=0.037)。新辅助化疗有效组3年DFS为96.2%(76/79),3年OS为100.0%(79/79),新辅助化疗无效组3年DFS为63.2%(12/19),3年OS为94.7%(18/19),3年DFS有统计学差异(P<0.001),3年OS无统计学差异(P=0.194)。结论:TP方案较TAC方案在三阴性乳腺癌新辅助化疗中有较好的完全缓解率,总有效率无差异,新辅助化疗有效性可转化为较好的预后。     

乳腺癌分子分型在新辅助化疗疗效及预后预测中的作用

目的:探讨乳腺癌分子分型在新辅助化疗疗效及预后预测中的作用.方法:收集漯河市中心医院收治的236例接受新辅助化疗患者的临床病理资料,分为Luminal A、Luminal B、Her-2阳性和三阴乳腺癌4种分子分型,分析分子分型与临床病理因素、新辅助化疗疗效及 5 年生存率的相关性.结果:236例患者中,107例(45.3%)为Luminal A亚型,47例(19.9%)为Luminal B亚型,27例(11.4%)为Her-2阳性亚型,55例(23.3%)为三阴乳腺癌亚型.Her-2阳性(25.9%)及三阴乳腺癌亚型(30.9%)的病理完全缓解(pCR)率明显高于Luminal亚型(Luminal A亚型 4.7%及Luminal B亚型 8.5%),差异有统计学意义(P<0.05).与Luminal亚型相比,Her-2阳性及三阴乳腺癌亚型具有更差的5年无病生存和总生存(P<0.01);获得pCR的乳腺癌患者的5年无病生存和总生存明显高于化疗后仍有癌残留的患者(P<0.05).结论:相对于Luminal亚型,Her-2 阳性和三阴乳腺癌亚型对新辅助化疗更为敏感,更易达到pCR;但是Her-2阳性和三阴乳腺癌亚型预后反而更差.     

T4期乳腺癌患者改良根治术后胸壁放疗加量的疗效及预后分析

目的分析T4期乳腺癌患者改良根治术后胸壁放疗加量的疗效。方法回顾分析2000-2016年收治的148例T4期、改良根治术后放疗的乳腺癌患者资料,胸壁放疗加量组57例,不加量组91例。放疗采用常规+胸壁电子线、三维适形+胸壁电子线、调强放疗+胸壁电子线照射,加量组EQD2>50Gy。全组患者均接受新辅助化疗。Kaplan-Meier法生存分析并Logrank检验差异,Cox模型多因素预后分析。结果中位随访时间67.2个月,5年胸壁复发(CWR)、局部区域复发(LRR)、无瘤生存(DFS)、总生存(OS)率分别为9.9%、16.2%、58.0%、71.4%。胸壁放疗加量和不加量的5年CWR、LRR、DFS、OS率分别为14%和7%、18%和15%、57%和58%、82%和65%(P>0.05)。多因素分析显示胸壁加量与否对预后无显著影响(P>0.05)。45例复发高危组患者中放疗加量组似乎有较高的OS率(P=0.058)、DFS率(P=0.084)和较低的LRR率(P=0.059)。结论T4期乳腺癌患者异质性较强,胸壁放疗加量对全组患者无明显获益。对于有脉管瘤栓阳性、pN2-N3、激素受体阴性中2~3个高危因素患者胸壁放疗加量有改善疗效趋势。     

早期乳腺癌患者保乳术联合术后放疗与乳房全切术的疗效对比

目的:探讨早期乳腺癌患者保乳术联合术后放疗与乳房全切术的远期疗效。方法:回顾性分析126例保乳手术联合术后放疗与144例乳房全切术治疗早期乳腺癌患者临床病理资料及随访结果,对比两组患者的5年总生存率（overall survival,OS）、无病生存率（disease-free survival,DFS）,采用单因素及多因素Cox回归分析两组患者临床病理资料对局部区域复发（local regional recurrence,LRR）及总生存的影响因素。结果:所有患者中位随访时间(84.890±20.474)个月,两组患者临床病理资料差异均无统计学意义（P>0.05）。保乳组:5年总生存率97.6%,5年无病生存率96.8%;乳房全切术组:5年总生存率97.2%,5年无病生存率97.2%,两组5年总生存率、无病生存率均无差异（P>0.05）。Cox多因素回归分析显示,HER-2过表达与局部区域复发率［HR:3.036(95%CI:1.084~8.504)］及总生存率［HR:3.767(95%CI:1.115~12.727)］均相关。结论:早期乳腺癌患者保乳术联合放疗与乳房全切术在5年总生存率、无病生存率方面无显著差异（P均>0.05）。HER-2过表达是影响早期乳腺癌局部区域复发率及总生存率的独立危险因素。在未来的治疗过程中,更倾向于选择保乳术联合术后放疗对早期乳腺癌患者进行治疗。     

进展期胃癌新辅助化疗期间伴急性上消化道出血患者的生存分析

  目的  探讨进展期胃癌新辅助化疗期间合并急性上消化道出血(acute upper gastrointestinal bleeding, AUGB)患者的临床特征和生存预后。  方法  回顾性分析河北医科大学第四医院自2015年1月至2017年1月行术前新辅助化疗的476例胃癌患者, 筛选出新辅助治疗期间出现AUGB的患者, 分析临床特征及影响预后的因素。  结果  476例胃癌患者行新辅助化疗期间出现AUGB者35例(7.35%), 其中经补液止血保守治疗好转者6例, 内镜下成功止血者5例, 血管造影栓塞术成功止血者7例, 余17例患者均行剖腹探查手术止血。全组患者3年总生存率(overall survival, OS)为65.13%, 3年无病生存率(disease-free survival, DFS)为60.71%。其中出现AUGB者3年OS为48.57%, 3年DFS为42.86%, 而未出现AUGB者3年OS、DFS分别为66.44%、62.13%, 两组患者的3年OS、DFS差异均具有统计学意义(P=0.033、P=0.025)。Cox比例风险模型多因素分析发现, 肿瘤组织学类型为低分化-未分化型(P=0.004、P=0.008)、肿瘤cTNM分期为Ⅲ期(P=0.002、P=0.013)和出现AUGB后未继续行化疗治疗(P=0.003、P=0.005)是影响AUGB患者预后及复发的独立危险因素。  结论  进展期胃癌患者进行新辅助化疗期间出现AUGB与多种危险因素有关, 此类患者需引起临床重视; 新辅助化疗期间出现AUGB后需积极对症止血治疗, 止血成功后继续化疗才可能延长此类患者生存期。      

乳腺癌新辅助化疗残余肿瘤组织病理信息与预后分析

目的 探讨乳腺癌新辅助化疗前后肿瘤组织病理信息的变化及对预后的影响。方法 对2014年1月—2016年5月就诊于辽宁省肿瘤医院乳腺外科并行规范乳腺癌新辅助化疗的177例患者回顾性分析,探讨乳腺癌新辅助化疗前后肿瘤组织病理信息的变化,并分析残余肿瘤组织病理信息对无病生存期(DFS)和总生存期(OS)的影响。结果 177例乳腺癌患者中位随访时间为37个月,37个月无病生存率和总生存率分别为84.0%和95.0%,4年无病生存率和总生存率分别为79.7%和81.1%。新辅助化疗后乳腺癌患者的DFS独立危险因素为原始T分期、原始N分期、存在脉管侵袭、新辅助化疗后Ki-67增加。OS的独立危险因素为原始T分期、原始N分期。而新辅助化疗前后ER状态的改变、PR状态的改变、HER-2状态的改变与患者预后无关(P＞0.05)。结论 乳腺癌新辅助化疗前后分子生物学指标ER、PR、HER-2、Ki-67可以发生改变,但与乳腺癌患者预后无关。原始肿瘤T分期、原始肿瘤N分期、存在脉管侵袭和Ki-67增加是影响乳腺癌患者DFS的危险因素。原始肿瘤T分期、原始肿瘤N分期是影响乳腺癌患者OS的危险因素。     

炎性乳腺癌临床病理特征与化疗疗效及预后的相关性分析

  目的  探讨炎性乳腺癌（inflammatory breast cancer,IBC）患者临床病理特征与新辅助化疗疗效及预后的相关关系。  方法  回顾性分析天津医科大学肿瘤医院2010年1月至2013年12月收治且接受新辅助化疗的81例IBC患者临床资料,应用单因素及多因素统计学方法分析其临床病理特征对化疗疗效及预后的影响。  结果  所有患者3年总生存（OS）率和无病生存（DFS）率分别为53.1%和37.0%,患者接受新辅助化疗后的病理完全缓解（pathologic complete response,pCR）率为13.6%（11/81）。新辅助化疗后是否达到pCR与患者的病理类型和分子分型有关（P < 0.05）,但获得pCR并不会改善其预后（P > 0.05）,而IBC患者的术前淋巴结分期是OS和DFS的独立影响因素（均P < 0.05）,新辅助化疗方案和淋巴管癌栓情况是影响患者DFS的独立因素（P < 0.05）。  结论  IBC的临床病理特征影响患者对化疗的敏感性,同时通过对术前淋巴结分期和淋巴管癌栓状态的评估,可以预测疾病的预后,合理使用新辅助化疗方案,以期达到最佳的治疗效果。