【作者】 王坤； 廖宁； 郑登云； 周清； 李学瑞；

【Author】 Wang Kun Liao Ning Zheng Deng-Yun Zhou Qing Li Xue-Rui Department of breast cancer, Cancer Center, Guangdong Provincial People’ s Hospital, Guangzhou 510080, P.R.China

【机构】 广东省人民医院肿瘤中心乳腺科；

【摘要】 新辅助化疗在乳腺癌中的应用越来越广泛,已成为局部晚期乳腺癌的标准治疗模式。新辅助治疗具有降低肿瘤分期、提高可手术率、提供理想体内药敏模型等优点。但有关新辅助化疗对雌激素和孕激素受体的影响存在争议,受体表达的改变能影响激素受体的状态,对内分泌治疗的选择必然产生影响。我们通过对收治的76例局部晚期乳腺癌行新辅助化疗:EC方案(表阿霉素100mg／m2,环磷酰胺 600mg／m2)或未行新辅助化疗前后激素受体表达的免疫组化检测,以探讨新辅助化疗对激素受体的影响。采用免疫组化法,检测新辅助化疗前后和未化疗前后ER／PR表达程度和激素受体状态的变化。结果示新辅助化疗组23例患者(61 ％)和非新辅助化疗组18例患者(47％)出现ER／PR表达程度的改变,P=0．25。两组中都有2例(5％)患者出现激素受体状态的改变,P=0．99。ER／PR表达改变与月经状态,组织类型无关。初步研究结果提示两组中5％患者出现激素受体状态的改变是由标本取样引起,治疗策略应以手术后大体病理的免疫组化为最后标准。更多还原

【Abstract】 Objective: Neoadjuvant chemotherapy for breast cancer was widely used in locally advanced inoperable disease in order to achieve surgical resection. It was benefited to operable breast cancer with a view to downstaging tumours to facilitate breast-conserving surgery. But its effect on estrogen and progesterone receptor (ER/PR) expression and hormone receptor (HR) status is controversial. Our study was to investigate the effect of neoadjuvant chemotherapy on estrogen and progesterone receptor expression and hormone receptor status in breast cancer. Methods: The changes of estrogen and progesterone receptor expression and hormone receptor status were studied by immunohistochemical method in neoadjuvant chemotherapy and non-neoadjuvant chemotherapy patients. Results: The ER/PR expression changed in 23(61%) neoadjuvant chemotherapy patients and 27(47 %) control patient, p = 0.25. These expression changes resulted in HR status(positive/negative) alterations in 2 patients(5 %) in both groups, p = 0.99. Status of menstructure and histology did not predict change. Conclusion: Hormone receptor status changed in 5% of neoadjuvant chemotherapy and control groups due to tissue sampling. As these changes may impact treatment, HR expression reanalysis in flnal surgical specimens is recommended.更多还原