【摘要】 目的探讨三阴乳腺癌(TNBC)与非三阴乳腺癌(non-TNBC)接受表阿霉素联合多西紫杉醇方案(ET方案)的化疗敏感性及预后方面的差别。方法对接受ET新辅助化疗方案治疗的249例乳腺癌患者进行回顾性分析。依据免疫组化雌激素受体(ER)、孕激素受体(PR)、表皮生长因子受体2(HER2)表达水平将乳腺癌分为三阴乳腺癌及非三阴乳腺癌两类,分析三阴与非三阴乳腺患者接受ET新辅助化疗方案后,二者病理疗效及远期生存的差别。结果 249例患者中,54(21.7%)例为三阴乳腺癌,195(78.3%)例为非三阴乳腺癌。三阴乳腺癌的病理完全缓解(pCR)率为25.9%,明显高于非三阴乳腺癌的12.3%(P=0.019)。三阴乳腺癌患者,特别是新辅助化疗后仍有癌残留的患者,其5年无病生存率(DFS)及5年的总生存率(OS)均明显低于非三阴乳腺癌(P值均<0.05)。获得pCR的乳腺癌患者5年的DFS和OS均明显高于化疗后仍有癌残留的患者(P值均<0.05)。获得pCR的三阴乳腺癌与非三阴乳腺癌患者的DFS(P=0.837)及OS(P=0.398)均无统计学差异。结论本研究结果表明,相比于非三阴乳腺癌患者,三阴乳腺癌患者具有更高的病理完全缓解率,但预后却较差。更多还原

【Abstract】 Objective To compare the response to neoadjuvant epirubicin plus docetaxel chemotherapy and survival in patients with Triple-negative breast cancer(TNBC) and non-TNBC.Methods Two hundred and forty-nine patients treated with neoadjuvant chemotherapy were included in this retrospective study.All the patients were classified as TNBC and non-TNBC according the immunohistochemical results of estrogen receptor(ER),progesterone receptor(PR) and HER2 status.TNBC is defined as the lack of ER,PR,and HER-2 expression.The pathological response and long time survival were compared between TNBC patients and non-TNBC patients.Results Among all 249 cases,54(21.7%)were TNBC patients,195(78.3%)were non-TNBC patients.Compared with non-TNBC patients,the pathological complete response(pCR) rate of patients with TNBC was 25.9%,which was significantly higher than that of patients with non-TNBC(P=0.019).Patients with TNBC especially for those with residual disease after chemotherapy had decreased 5 years’ disease-free survival(DFS) and 5 years’ overall survival(OS) compared with those with non-TNBC(P<0.05).The 5 years’ DFS and OS of patients who achieve pCR were significantly higher than that of patients with residual disease after chemotherapy(P<0.05).Patients with TNBC and non-TNBC had similar DFS and OS if pCR achieved.Conclusion Patients with TNBC were more sensitive to neoadjuvant docetaxel plus epirubicin chemotherapy.Compared with non-TNBC patients,TNBC patients had increased pCR rate,but were associated with significantly worse survival.更多还原