摘要
目的分析乳腺癌易感基因1(BRCA1)和乳腺癌易感基因2(BRCA2)阴性家族性与散发性乳腺癌患者的临床特征及影响新辅助化疗疗效的因素。方法回顾性分析393例BRCA1与BRCA2基因突变检测结果为阴性的乳腺癌患者的临床资料,其中家族性乳腺癌54例为A组,散发性乳腺癌339例为B组。通过免疫组化法对两组乳腺癌组织标本中的人表皮生长因子受体2(HER-2)、孕激素受体(PR)及雌激素受体(ER)进行检测。比较两组临床病理特征及化疗后病理完全缓解率的差异,并采用单因素及多因素Logistic回归分析影响新辅助化疗疗效的相关因素。结果 A组患者发病年龄≤30岁、双侧乳腺癌的比率较B组均显著升高(P<0.05);两组患者在病理类型、肿瘤直径、组织学分级、HER-2表达、ER表达、PR表达、淋巴结转移状态和新辅助化疗、三阴性乳腺癌的比率比较,均无显著差异(P>0.05)。经单因素、多因素Logistic回归分析结果均发现,BRCA1、BRCA2阴性乳腺癌患者新辅助化疗的临床疗效与肿瘤直径、组织学分级和是否为家族性乳腺癌、三阴性乳腺癌均存在显著关系(P<0.05)。结论相比BRCA1、BRCA2阴性的散发性乳腺癌患者,BRCA1、BRCA2阴性的家族性乳腺癌患者发病年龄较早,且双侧乳腺癌的占比较高,其在新辅助化疗后的病理完全缓解率较高,因此其有着独特的临床病理特征,患者对新辅助化疗较为敏感。
Objective To analyze the clinical characteristics of breast cancer susceptibility gene 1(BRCA1)and breast cancer susceptibility gene 2(BRCA2)negative familial and sporadic breast cancer and the factors influencing the efficacy of neoadjuvant chemotherapy.Methods The clinical data of 393 cases of breast cancer with negative results of BRCA1 and BRCA2 gene mutation in our hospital were retrospectively analyzed.Among of them,54 cases of familial breast cancer were selected as group A,339 cases of sporadic breast cancer as group B.Human epidermal growth factor receptor 2(HER-2),progesterone receptor(PR)and estrogen receptor(ER)were detected by immunohistochemistry in two groups of breast cancer tissues.The clinical pathological characteristics and the complete remission rate after chemotherapy were compared between the two groups.Univariate and multivariate Logistic regression analysis were used to analyze the related factors influencing the efficacy of neoadjuvant chemotherapy.Results In the group A,the proportion of age≤30 years and bilateral breast cancer were significantly higher than those in the group B(P<0.05).The pathological type,tumor size,histological grade,HER-2 expression,ER expression,PR expression,lymph node metastasis and the proportion of neoadjuvant chemotherapy and thriple negative breast cancer in the two groups showed no significant difference(P>0.05).The results of univariate and multivariate Logistic regression analysis showed that the clinical efficacy of neoadjuvant chemotherapy in patients with BRCA1 and BRCA2 negative breast cancer was significantly correlated with tumor diameter,histological grade,and whether it was familial breast cancer or three negative breast cancer(P<0.05).Conclusion Compared with patients with BRCA1,BRCA2 negative sporadic breast cancer,patients with BRCA1,BRCA2 negative familial breast cancer at an earlier age,and bilateral breast cancer is relatively high,with high pathological complete remission rate of neoadjuvant chemotherapy treatment.It has unique clinicopathologic features and the patients are more sensitive to neoadjuvant chemotherapy.
作者
黄倩
钟亚春
徐曼
HUANG Qian;ZHONG Ya-chun;XU Man(Department of Primary Breast Surgery,Wuhan No.1 Hospital,Wuhan Hubei 430022,China)
出处
《临床和实验医学杂志》
2018年第8期861-864,共4页
Journal of Clinical and Experimental Medicine
关键词
乳腺癌
乳腺癌易感基因1
乳腺癌易感基因2
临床病理特征
新辅助化疗
影响因素
Breast cancer
Breast cancer susceptibility gene 1
Breast cancer susceptibility gene 2
Clinicopathological feature
Neoadjuvant chemotherapy
Influencing factor
