全乳腺大切片观察新辅助化疗后乳腺癌收缩方式及 - 第三军医大学学报.doc

乳腺癌新辅助化疗后残留灶分型与ER、PR、Her-2的关系 王姝姝，张 毅，齐晓伟，陈庆秋姜军（） ［中图法分类号］ R602;R73-34;R737.9 ［文献标志码］ A Correlation between types of residual tumor and ER, PR, HER-2 after neoadjuvant chemotherapy for breast cancer Wang Shushu, Zhang Yi, Qi Xiaowei, Chen Qingqiu, Jiang Jun (Breast Disease Center, Southwest Hospital, Third Military Medical University, Chongqing 400038, China) [Abstract］ Objective To study the correlation between types of residual tumor and ER, PR, HER-2 after neoadjuvant chemotherapy for breast cancer. Methods Samples were collected from 90 women with stages II and III invasive ductal carcinoma during mastectomy. The samples were cut into sections. The morphology of residual tumor was observed and typed under microscope after neoadjuvant chemotherapy. Expression of ER, PR and HER-2 was detected by immunohistochemistry (IHC). Correlation between expression levels of ER, PR and HER-2 in different types of residual tumor was analyzed before and after neoadjuvant chemotherapy. Results The residual tumor was divided into typeⅠ(solitary residual tumor), typeⅡ(multifocal residual tumor) and type Ⅲ(main mass with smaller satellite nodules), accounting for 61% (55/90), 33% (30/90) and 6% (5/90), respectively. No significant difference was observed in expression levels of ER, PR, HER-2 before and after neoadjuvant chemotherapy (P＞0.05). expression levels of ER, PR and HER-2 were lower after neoadjuvant chemotherapy than before neoadjuvant chemotherapy. Conclusion ER, PR and HER-2 cannot be used to evaluate the types of residual tumor after neoadjuvant chemotherapy. MRI in combination with sub-serial section of total breast should be used to show the morphology of residual tumor before operation. ［Key words］ breast cancer; neoadjuvant chemotherapy; estrogen receptor; progesterone receptor; human epidermal growth factor receptor 新辅助化疗（neoadjuvant chemotherapy）已普遍应用于可手术及不可手术乳腺癌的辅助治疗，可使需行全乳房切除术的原发肿瘤降期后行保留乳房手术，但是研究显示降期后保乳手术局部复发率较原发肿瘤符合保乳条件而采取保乳 __________