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目的探讨乳腺癌分子分型对多西他赛+表阿霉素新辅助化疗的临床疗效及预后的预测价值。方法对126例行多西他赛+表阿霉素新辅助化疗的老年乳腺癌患者的肿瘤组织行免疫组织化学检测,依据雌激素受体(ER)、孕激素受体(PR)、人类表皮生长因子受体2(HER2)表达情况及Ki67水平,将乳腺癌分三阴型、HER2过表达型、Luminal A型、Luminal B型,分析不同分子分型患者病理完全缓解率(p CR)的差异,比较不同分子分型患者术后无病生存时间(DFS)和总生存时间(OS)。结果乳腺癌分子分型各组p CR依次为三阴型(42.1%)、HER2过表达型(30.8%)、Luminal A型(13.2%)和Luminal B型(4.7%),三阴型和HER2过表达型者的临床总有效率分别为94.7%和80.8%,高于Luminal A型的63.7%和Luminal B型的55.9%(P<0.05)。Cox回归分析显示,分子亚型为影响乳腺癌临床疗效的独立因素,以三阴型为对照,Luminal A型、Luminal B型的OR值分别为1.885和2.317。Luminal A型患者的OS、DFS均高于三阴型(χ~2=3.176,P=0.032;χ~2=3.743,P=0.029)。结论以ER、PR、HER2、Ki67为依据的乳腺癌分子分型可能是老年乳腺癌多西他赛+表阿霉素新辅助化疗后p CR、OS、DFS的预测指标。
Objective To investigate the clinical efficacy and prognosis of breast cancer molecular typing on docetaxel + epirubicin neoadjuvant chemotherapy. Methods Tumor tissue from 126 elderly patients with docetaxel and epirubicin neoadjuvant chemotherapy were detected by immunohistochemistry. The expressions of estrogen receptor (ER), progesterone receptor (PR), human epidermis The expression of HER2 and the level of Ki67 in breast cancer were analyzed by semi-negative, HER2 overexpression, Luminal A, and Luminal B types, and the pathological complete response rates (p CR) of patients with different molecular types were analyzed Differences in patients with different molecular typing patients with disease-free survival time (DFS) and total survival time (OS). Results The expression of p CR in breast cancer was 42.1%, HER2 overexpression (30.8%), Luminal A (13.2%) and Luminal B (4.7%), The overall clinical response rates were 94.7% and 80.8% for those with overexpression, up from 63.7% for Luminal A and 55.9% for Luminal B (P <0.05). Cox regression analysis showed that the molecular subtypes were independent factors affecting the clinical efficacy of breast cancer. The triple-negative control was used as the control. The OR values of Luminal A and Luminal B were 1.885 and 2.317, respectively. Patients with Luminal A had higher OS and DFS than those with triple-negative (χ ~ 2 = 3.176, P = 0.032; χ ~ 2 = 3.743, P = 0.029). Conclusion The molecular typing of breast cancer based on ER, PR, HER2 and Ki67 may be the predictive value of p CR, OS and DFS after chemotherapy with docetaxel and epirubicin in elderly patients with breast cancer.