Koonmee Supinda, Somintara Ongart, Intarawichian Piyapharom, Aphivatanasiri Chaiwat, Sangkhamanon Sakkarn, Laohawiriyakamol Suphawat, Panawattanakul Rujira, Mahantassanapong Phanchanut, Rattadilok Chayanoot, Jeeravongpanich Piyarat, Krongyute Wilart, Prachumrasee Krisada, Alaghehbandan Reza
Department of Pathology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.
Department of Surgery, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.
Cancer Manag Res. 2021 Nov 23;13:8737-8753. doi: 10.2147/CMAR.S335386. eCollection 2021.
Breast cancer is a growing public health challenge in Thailand. Pathum Raksa project was launched in 2015, as a result of higher than expected rate of triple-negative breast cancers in Thai women. The purpose of this project was to identify the cause(s) and address the issue(s), hence improving the quality of breast cancer biomarker testing in Thailand.
Nineteen hospitals across the country, with 902 breast cancer patients were enrolled in this study during 2015-2020. The pre- and post-data from Pathum Raksa initiative was only available for Khon Kaen University (KKU) and Udonthani hospitals in Northeast Thailand. We developed a resource-stratified strategic plan that included designing a unique specimen container, forming multidisciplinary teams from the Surgery and Pathology Departments, and employing locally developed innovative technologies to optimize the entire process of breast cancer diagnostics and biomarker testing.
The rate of triple-negative breast cancers in KKU and Udonthani decreased 52.8% ( = 0.02) and 28.9% ( = 0.48), respectively. The rate of ER+ breast cancers in both hospitals increased 5% post-Pathum Raksa implementation. The rate of HER2-neu+ (score 3+) also increased in both hospitals (particularly an increased 65% rate in KKU). Luminal A/B cancers were the most common subtype in both KKU and Udonthani hospitals.
Pathum Raksa project has significantly improved breast cancer biomarker testing in Thailand. As a result of this national innovation, false-negative rates of breast biomarkers have significantly decreased, resulting in improving prognosis, treatment, and survival of breast cancer women in Thailand.
乳腺癌对泰国的公共卫生构成了日益严峻的挑战。帕通·拉卡萨项目于2015年启动，原因是泰国女性三阴性乳腺癌的发病率高于预期。该项目的目的是找出病因并解决问题，从而提高泰国乳腺癌生物标志物检测的质量。
2015年至2020年期间，泰国全国19家医院的902名乳腺癌患者参与了本研究。帕通·拉卡萨倡议的前后数据仅适用于泰国东北部的孔敬大学（KKU）和乌隆他尼医院。我们制定了一项资源分层战略计划，包括设计一个独特的标本容器，组建外科和病理科的多学科团队，并采用当地开发的创新技术来优化乳腺癌诊断和生物标志物检测的全过程。
KKU和乌隆他尼的三阴性乳腺癌发病率分别下降了52.8%（P = 0.02）和28.9%（P = 0.48）。帕通·拉卡萨项目实施后，两家医院的雌激素受体阳性（ER+）乳腺癌发病率均上升了5%。两家医院的人表皮生长因子受体2（HER2-neu+，评分3+）发病率也有所上升（尤其是KKU上升了65%）。管腔A型/B型癌症是KKU和乌隆他尼医院最常见的亚型。
帕通·拉卡萨项目显著改善了泰国乳腺癌生物标志物检测。这项全国性创新成果使乳腺癌生物标志物的假阴性率显著降低，从而改善了泰国乳腺癌女性的预后、治疗和生存率。
