Prognostic Value of a Positive-to-negative Change in Hormone Receptor Status after Neoadjuvant Chemotherapy in Patients with Hormone Receptor-positive Breast Cancer
Prognostic Value of a Positive-to-negative Change in Hormone Receptor Status after Neoadjuvant Chemotherapy in Patients with Hormone Receptor-positive Breast Cancer
复制标题
激素受体阳性乳腺癌患者新辅助化疗后激素受体状态从阳性到阴性变化的预后价值
DOI：
10.1245/s10434-012-2318-2
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发表时间：
2012-09-01
影响因子：
3.7
通讯作者：
Shao, Zhi-Ming
中科院分区：
文献类型：
--
作者：
Chen, Sheng;Chen, Can-Ming;Shao, Zhi-Ming
目的 探讨新辅助化疗（NCT）后激素受体（HR）状态从阳性到阴性变化对 HR 阳性乳腺癌患者的预后价值。收集了 224 例 NCT 前 HR 状态阳性且 NCT 后乳腺有残留病灶的 II-III 期乳腺癌患者的数据。 NCT 后重新测试残留肿瘤的 HR 状态。对 214 名接受辅助内分泌治疗的患者进行了生存分析，无论 NCT 后 HR 状态如何。生存分析还检查了其他临床和病理变量。总共有 15.2% 的患者在 NCT 后 HR 状态出现从阳性到阴性的变化，这种变化在 HER-2 阳性肿瘤中比 HER-2 阴性肿瘤中更常见 (P = 0.001)。在 214 名接受辅助内分泌治疗的患者中，无论 NCT 后 HR 状态如何，HR 状态的改变是预测辅助内分泌治疗患者无病生存率 (P = 0.026) 和总生存率 (P < 0.001) 较差的独立因素。 HR状态转变的患者的5年无病生存率和总生存率分别为43.5%和59.8%，HR状态保持阳性的患者的5年无病生存率和总生存率分别为67.8%和82.5%（对数秩检验P=0.003和P=0.001）。NCT后HR状态的转变对于HR阳性肿瘤来说是显着的。 HR 阴性转换可能会识别出可从替代全身疗法中受益的患者。
To investigate the prognostic value of positive-to-negative changes in hormone receptor (HR) status after neoadjuvant chemotherapy (NCT) in patients with HR-positive breast cancer.Data from 224 stage II-III breast cancer patients with positive HR status before NCT who had residual disease in the breast after NCT were collected. HR status of the residual tumors was retested after NCT. A survival analysis was performed in 214 patients with adjuvant endocrine therapy regardless of post-NCT HR status. The survival analysis also examined other clinical and pathologic variables.In total, 15.2 % of patients had a positive-to-negative change in HR status after NCT, and this change was observed more frequently in HER-2-positive tumors than HER-2-negative tumors (P = 0.001). In 214 patients who had been treated with adjuvant endocrine therapy regardless of post-NCT HR status, the alteration in HR status was an independent factor for the prediction of a poorer disease-free survival (P = 0.026) and overall survival (P < 0.001) in the adjuvant endocrine therapy patients. The 5-year disease-free survival and overall survival rates were 43.5 % and 59.8 %, respectively, in patients with HR status conversion and 67.8 % and 82.5 %, respectively, in patients whose HR status remained positive (log rank test P = 0.003 and P = 0.001).The switch of HR status after NCT is remarkable for HR-positive tumors. An HR-negative switch may identify patients who would benefit from alternative systemic therapies.