摘要
目的：分析新辅助化疗在乳腺癌手术患者中的应用效果，进一步探讨其作用机制，为其临床应用提供可靠的依据。方法选取浙江省肿瘤医院乳腺科2010年1月至2014年6月接收的425例女性乳腺癌患者作为研究对象，入院后据患者意愿分为对照组（n＝322）和观察组（n＝103）。对照组患者给予常规手术治疗；观察组患者在对照组的基础上给予新辅助化疗。统计分析2组临床疗效和不良反应发生率；比较2组治疗前后血管内皮生长因子（ vascular endothelial growth factor ，s-VEGF）、微血管密度（ mi-crovessel density ，MVD）水平变化；比较2组治疗前后VEGF-A、VEGF-C阳性率与雌激素受体（ estrogen re-ceptor，ER），孕激素受体（progesterone receptor ，PR）、人表皮生长因子受体（human epidermal growth factor re-ceptor-2，HER2）、抑癌基因转录蛋白p534个免疫组化指标阳性率变化。结果观察组总有效率明显高于对照组（77.7％ vs 53.7％，χ2＝18.6，P＜0.05）；2组不良反应发生率比较，差异无统计学意义（9.7％ vs 5.3％，χ2＝2.57，P＞0.05）。2组治疗前s-VEGF和MVD差异均无统计学意义（P＞0.05）；治疗后，观察组s-VEGF和MVD水平显著低于对照组（ P＜0.05）。2组治疗前VEGF-A、VEGF-C、ER、PR、HER2、p53阳性率比较差异均无统计学意义（ P＞0.05）；治疗后，观察组VEGF-A、VEGF-C、ER、PR、HER2、p53阳性率均显著低于对照组（ P＜0.05）。结论 NAC有助于提高乳腺癌手术患者的有效率，在减少乳腺癌患者的s-VEGF和MVD水平，降低VEGF-A、VEGF-CER、PR、HER2及p53阳性率方面有正向意义，能有效辅助治疗乳腺癌，不良反应小，值得在临床上推广应用。
Objective To analyze the effect of neoadjuvant chemotherapy in patients with breast cancer , and further to explore its mechanism in order to provide a reliable basis for its clinical application .Methods 425 cases of breast cancer patients admitted from Jan .2010 to Jun.2014 were the research object , and they were divided into the control group（n=322）and the observation group（n=103）.The control group received operation treatment and the observation group were added with neoadjuvant chemotherapy besides routine operation treat -ment.Incidence of clinical efficacy and adverse reactions of the 2 groups were statistically analyzed .Changes of vascular endothelial growth factor （ s-VEGF） and microvessel density （ MVD） levels before and after treatment were compared between the 2 groups.VEGF-A, the positive rate of VEGF-C and estrogen receptor（ER）, progesterone receptor（PR）, human epidermal growth factor receptor-2（HER2）, and P53 before and after treatment were com-pared between the 2 groups.Results The total effective rate was obviously higher in the observation group than in the control group（77.7%vs 53.7%,χ2 =18.6, P〈0.05）.The adverse reaction rate had no statistical sig-nificance between the 2 groups（9.7% vs 5.3%, χ2 =2.57, P〉0.05）.s-VEGF and MVD had no statistical difference between the 2 groups before treatment（P〉0.05）while they were significantly lower in the observation group than those in the control group after treatment （P〈0.05）.The positive rate of VEGF-A, VEGF-C, ER, PR, HER-2, and P53 had no statistical difference while they were obviously lower in the observation group than those in the control group （ P〈0.05 ） .Conclusions NAC can help to improve the operation efficiency in pa-tients with breast cancer , reduce s-VEGF and MVD levels and play a role in reducing the positive rate of VEGF-A, VEGF-CER, PR, HER-2 and P53.It is an effective adjuvant treatment for breast cancer with less adverse re-actions, which is worthy of clinical application .
出处
《中华内分泌外科杂志》
CAS
2015年第5期390-394,共5页
Chinese Journal of Endocrine Surgery
关键词
乳腺癌
新辅助化疗
血管内皮生长因子
免疫组化
Breast cancer
Neoadjuvant chemotherapy
Vascular endothelial growth factor
Im-munohistoehemistry
