【摘要】 目的:探讨人表皮生长因子受体2(HER2)阳性乳腺癌新辅助化疗(NAC)疗效的影响因素及列线图预测模型建立。方法:选取96例HER2阳性乳腺癌患者为研究对象，根据NAC是否获得病理完全缓解(pCR)分为pCR组(n=36)和非pCR组(n=60)。采用Logistic回归分析法确立影响HER2阳性乳腺癌患者NAC疗效的因素，并构建疗效列线图模型，应用受试者工作特征(ROC)曲线验证模型的预测效能。结果:96例患者中，36例获得pCR,获得率37.50%。pCR组患者年龄>40岁、体质指数(BMI)>24 kg/m~2、有病灶钙化、组织学分级高、Ki-67表达≥15、HR阴性、肿瘤浸润淋巴细胞阳性、BPE下降明显的占比高于非pCR组(P<0.05)。回归分析显示，组织学分级、HR状态、肿瘤浸润淋巴细胞状态及BPE是影响HER2阳性乳腺癌患者NAC疗效的预测因素(P<0.05)。HER2阳性乳腺癌患者NAC疗效列线图预测模型的ROC曲线下面积(AUC)为0.776(95%CI:0.679～0.855),敏感度为75.00%,特异度为73.33%。结论:组织学分级、HR状态、肿瘤浸润淋巴细胞状态及BPE是影响HER2阳性乳腺癌患者NAC疗效的预测因素，基于以上因素构建的列线图模型对NAC疗效影响因素有较好的预测效能。更多还原

【Abstract】 Objective:To investigate the influencing factors on the efficacy of neoadjuvant chemotherapy(NAC) for human epidermal growth factor receptor 2(HER2)-positive breast cancer, and to construct its line chart prediction model.Methods:96 HER2 positive breast cancer patients were selected as research objects, and divided into pCR group(n=36) and non-pCR group(n=60) according to NAC efficacy [whether pathological complete remission(pCR) was obtained].Logistic regression analysis was used to establish the factors affecting the efficacy of NAC in HER2-positive breast cancer patients.The line graph model of NAC efficacy in HER2-positive breast cancer patients was constructed according to the Logistic regression results.The receiver operating characteristic(ROC) curve was used to verify the predictive efficacy of the model.Results:Among the 96 patients, 36 received pCR,with the acquisition rate of 37.50%.The proportion of age > 40 years old, BMI > 24 kg/m~2,calcification, high histological grade, Ki-67 expression ≥ 15,HR negative, tumor infiltrating lymphocytes positive and BPE decreased significantly in pCR group were higher than those in non-pCR group(P<0.05).Multivariate logistic regression analysis showed that histological grade, HR status, tumor infiltrating lymphocyte status and BPE were predictors of NAC efficacy in HER2 positive breast cancer patients(P<0.05).The AUC under ROC curve of the prediction model of NAC efficacy in HER2 positive breast cancer patients was 0.776(95%CI:0.679～0.855),the sensitivity was 75.00 %,and the specificity was 73.33 %.Conclusion:Histological grade, HR status, tumor infiltrating lymphocyte status and BPE are predictors of NAC efficacy in HER2 positive breast cancer patients, and the line chart model based on the above factors has a good prediction effect on the influencing factors of NAC efficacy.更多还原