原发灶激素受体阴性腋淋巴结转移灶激素受体阳性乳腺癌 患者的内分泌治疗
| 作者: |
1郑向欣,
1吴骥,
1顾书成,
1江小玲,
1侍孝红,
1袁牧,
1陆柏林,
1邱兴,
1张旭旭,
1柏建印,
1管小青
1 南京鼓楼医院集团宿迁市人民医院 1. 乳腺外科 2. 病理科，江苏 宿迁 223800 |
| 通讯: |
管小青
Email: guan_dr@163.com |
| DOI: | 10.3978/.10.3978/j.issn.1005-6947.2017.11.014 |
摘要
目的: 探讨内分泌治疗对原发灶激素受体(HR)阴性，腋淋巴结转移灶 HR 阳性乳腺癌患者的临床效果。
方法: 将 2011 年 1 月—2016 年 1 月收治的 67 例原发灶 HR 阴性，腋淋巴结转移灶 HR 阳性乳腺癌患 者随机分为观察组(33 例)与对照组(34 例)，两组术后放化疗方案相同，观察组化疗结束后给予三 苯氧胺(绝经前患者)或来曲唑(绝经后患者)，比较两组患者的复发转移及生存情况。
结果: 所有患者随访 12~60 个月，期间观察组有 13 例患者出现复发转移，死亡 7 例;对照组有 19 例 患者出现复发转移，死亡 15 例;两组复发转移发生率无统计学差异(P>0.05)，观察组复发转移 死亡的比例明显低于对照组(P<0.05)。观察组患者 1、3、5 年无病生存率(DFS)分别为 100%、 81.8%、72.7%，1、3、5 年总生存率(OS)分别为 100%、90.9%、81.8%(27/33);对照组患者 1、 3、5 年 DFS 分别为 100%、58.8%、47.1%，1、3、5 年 OS 分别为 100%、70.6%、58.8%;观察组 3、 5 年 DFS 和 OS 均明显高于对照组(均 P<0.05)。
结论: 乳腺癌患者原发灶与腋淋巴结转移灶的分子分型值得重视;术后内分泌治疗可以提高原发灶 HR 阴性，腋淋巴结转移灶 HR 阳性乳腺癌患者的生存率，降低死亡风险。
关键词：
乳腺肿瘤
激素拮抗药
无病生存
方法: 将 2011 年 1 月—2016 年 1 月收治的 67 例原发灶 HR 阴性，腋淋巴结转移灶 HR 阳性乳腺癌患 者随机分为观察组(33 例)与对照组(34 例)，两组术后放化疗方案相同，观察组化疗结束后给予三 苯氧胺(绝经前患者)或来曲唑(绝经后患者)，比较两组患者的复发转移及生存情况。
结果: 所有患者随访 12~60 个月，期间观察组有 13 例患者出现复发转移，死亡 7 例;对照组有 19 例 患者出现复发转移，死亡 15 例;两组复发转移发生率无统计学差异(P>0.05)，观察组复发转移 死亡的比例明显低于对照组(P<0.05)。观察组患者 1、3、5 年无病生存率(DFS)分别为 100%、 81.8%、72.7%，1、3、5 年总生存率(OS)分别为 100%、90.9%、81.8%(27/33);对照组患者 1、 3、5 年 DFS 分别为 100%、58.8%、47.1%，1、3、5 年 OS 分别为 100%、70.6%、58.8%;观察组 3、 5 年 DFS 和 OS 均明显高于对照组(均 P<0.05)。
结论: 乳腺癌患者原发灶与腋淋巴结转移灶的分子分型值得重视;术后内分泌治疗可以提高原发灶 HR 阴性，腋淋巴结转移灶 HR 阳性乳腺癌患者的生存率，降低死亡风险。
Efficacy of endocrinotherapy in breast cancer patients with hormone receptor negative primary lesion and positive axillary lymph node metastasis
CorrespondingAuthor:Guan Xiaoqing Email: guan_dr@163.com
Abstract
Objective: To investigate the clinical efficacy of endocrinotherapy in treatment of breast cancer patients with hormone receptor (HR)-negative primary lesion and HR-positive axillary lymph node metastases.
Methods: Sixty-seven breast cancer patients with HR-negative primary lesion and HR-positive axillary lymph node metastases admi ed from January 2011 to January 2016 were randomly designated to observation group (33 cases) and control group (34 cases). Patients in both groups received the same chemoradiotherapy regimen, while those in observation group were additionally given administration of tamoxifen (pre-menopausal patients) or letrozole (post-menopausal patients) a er chemotherapy. e recurrence/metastasis and survival rates of the two groups of patients were compared.
Results: All patients were followed up for 12 to 60 months, during which time, recurrence/metastasis occurred in 13 cases and death occurred in 7 cases in observation group, and recurrence/metastasis occurred in 19 cases and death occurred in 15 cases in control group. e incidence of recurrence/metastasis of the two groups showed no signi cant di erence (P>0.05), while the rate of death due to recurrence/metastasis was signi cantly lower in observation group than that in control group (P<0.05). e 1-, 3- and 5-year disease-free survival (DFS) rate was 100%, 81.8% and 72.7% in observation group and was 100%, 58.8% and 47.1% in control group respectively; the 1-, 3- and 5-year overall survival (OS) rate was 100%, 90.9% and 81.8% in observation group and was 100%, 70.6% and 58.8% in control group. Both 3- and 5-year DFS and OS in observation group were signi cantly higher than those in control group (all P<0.05).
Conclusion: A ention should be paid to the molecular classi cation of primary lesion and axillary lymph node metastasis in breast cancer patients. Postoperative endocrinotherapy may improve the survival and reduce the risk of death for breast cancer patients with HR-negative primary lesion and HR-positive axillary lymph node metastases.
Keywords：
Breast Neoplasms
Hormone Antagonists
Disease-Free Survival
Methods: Sixty-seven breast cancer patients with HR-negative primary lesion and HR-positive axillary lymph node metastases admi ed from January 2011 to January 2016 were randomly designated to observation group (33 cases) and control group (34 cases). Patients in both groups received the same chemoradiotherapy regimen, while those in observation group were additionally given administration of tamoxifen (pre-menopausal patients) or letrozole (post-menopausal patients) a er chemotherapy. e recurrence/metastasis and survival rates of the two groups of patients were compared.
Results: All patients were followed up for 12 to 60 months, during which time, recurrence/metastasis occurred in 13 cases and death occurred in 7 cases in observation group, and recurrence/metastasis occurred in 19 cases and death occurred in 15 cases in control group. e incidence of recurrence/metastasis of the two groups showed no signi cant di erence (P>0.05), while the rate of death due to recurrence/metastasis was signi cantly lower in observation group than that in control group (P<0.05). e 1-, 3- and 5-year disease-free survival (DFS) rate was 100%, 81.8% and 72.7% in observation group and was 100%, 58.8% and 47.1% in control group respectively; the 1-, 3- and 5-year overall survival (OS) rate was 100%, 90.9% and 81.8% in observation group and was 100%, 70.6% and 58.8% in control group. Both 3- and 5-year DFS and OS in observation group were signi cantly higher than those in control group (all P<0.05).
Conclusion: A ention should be paid to the molecular classi cation of primary lesion and axillary lymph node metastasis in breast cancer patients. Postoperative endocrinotherapy may improve the survival and reduce the risk of death for breast cancer patients with HR-negative primary lesion and HR-positive axillary lymph node metastases.