Liu Wen-qing, Ye Jing-ming, Xu Ling, Liu Qian, Zhao Jian-xin, Duan Xue-ning, Liu Yin-hua
Breast Disease Center, Peking University First Hospital, Beijing 100034, China.
Zhonghua Wai Ke Za Zhi. 2013 Aug;51(8):706-9.
To investigate the predictive value of molecular subtypes and the evaluational value of dynamic contrast-enhanced MRI of neoadjuvant chemotherapy for breast cancer.
From January 2010 to December 2011, the 79 patients diagnosed as primary invasive breast cancer, having received 6 cycles of neoadjuvant chemotherapy and finished the mastectomy or the breast conserving surgery entered this study. A total of 79 patients participated in this prospective study. There were 6 (7.6%) luminal A cases, 42 (53.2%) luminal B cases, 14 HER-2 (17.7%) positive cases and 17 (21.5%) triple negative cases. The associations between molecular subtypes and clinical response as well as the pathological response were analyzed. The predictive value of molecular subtypes for the neoadjuvant chemotherapy was studied.
Clinical effective rate was 85.3% (66/79). There was no statistical correlation between molecular subtypes and clinical effective rate. Pathologic effective rate was 79.7% (63/79). There was no statistical correlation between molecular subtypes and pathologic effective rate. Twenty-seven case achieved pathologic complete remission (pCR) in all the patients. No case achieved pCR in the patients classified as Luminal A. Twelve cases (28.6%, 12/42) achieved pCR in the luminal B patients.Five cases (5/14) achieved pCR in the HER-2 overexpression patients. Ten cases (10/17) achieved pCR in the triple-negative patients. There was a statistical correlation between the molecular subtypes and the pCR rate (P = 0.039), and between clinical evaluation by dynamic contrast-enhanced MRI and evaluation of pathological response (r = 0.432, P = 0.000).
Molecular subtypes and dynamic contrast-enhanced MRI have a good value of predicting and evaluating the response of neoadjuvant chemotherapy on breast cancer.
探讨分子亚型对乳腺癌新辅助化疗的预测价值及动态对比增强磁共振成像（MRI）对新辅助化疗的评估价值。
选取2010年1月至2011年12月期间诊断为原发性浸润性乳腺癌、接受6周期新辅助化疗并完成乳房切除术或保乳手术的79例患者纳入本研究。共有79例患者参与了这项前瞻性研究。其中管腔A型6例（7.6%），管腔B型42例（53.2%），HER-2阳性14例（17.7%），三阴性17例（21.5%）。分析分子亚型与临床反应以及病理反应之间的关联。研究分子亚型对新辅助化疗的预测价值。
临床有效率为85.3%（66/79）。分子亚型与临床有效率之间无统计学相关性。病理有效率为79.7%（63/79）。分子亚型与病理有效率之间无统计学相关性。所有患者中27例达到病理完全缓解（pCR）。管腔A型患者中无1例达到pCR。管腔B型患者中有12例（28.6%，12/42）达到pCR。HER-2过表达患者中有5例（5/14）达到pCR。三阴性患者中有10例（10/17）达到pCR。分子亚型与pCR率之间存在统计学相关性（P = 0.039），动态对比增强MRI的临床评估与病理反应评估之间也存在相关性（r = 0.432，P = 0.000）。
分子亚型和动态对比增强MRI对乳腺癌新辅助化疗反应具有良好的预测和评估价值。
