新辅助化疗后侵袭性乳腺癌的变化可能影响辅助治疗决策
Bárbara Jaime Dos Santos1, Débora Balabram2, Virginia Mara Reis Gomes1
1Laboratory of Mammary Pathology, Department of Anatomical Pathology and Forensic Medicine, Faculty of Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil.
Cancer research and treatment
|August 3, 2023
概括
新辅助化疗显著改变了侵袭性乳腺癌的特征和生物标志物. 重新评估这些残留样本的变化对于改善患者生存结果至关重要.
科学领域:
- 在瘤学瘤学.
- 乳腺癌研究研究 乳腺癌研究
- 化疗疗的有效性 化疗的有效性
背景情况:
- 新辅助化疗 (NACT) 是侵袭性乳腺癌 (IBC) 的标准治疗方法.
- NACT可以诱导瘤生物学和病理学的显著变化.
- 了解这些NACT后变化对于预测患者预后和整体存活率至关重要.
研究的目的:
- 为了确定新辅助化疗 (NACT) 后侵袭性乳腺癌 (IBC) 的特定变化.
- 研究这些NACT后瘤变化与患者整体存活率 (OS) 之间的关联.
主要方法:
- 在NACT前后评估来自86名患者的侵入性乳腺癌 (IBC) 样本.
- 病理和免疫组织化学特征 (IHC) 与整体存活率 (OS) 数据的相关性.
主要成果:
- NACT显著改变了核形,线粒细胞数,瘤透性炎症细胞,在位癌,淋巴血管入侵 (LVI) 和雌激素受体,孕激素受体 (PR) 和Ki67.7的表达.
- 免疫组织化学 (IHC) 概况在30.2%的瘤中发生变化.
- 较高的死亡风险与高初始组织学等级,高核形,高Ki67,NACT后LVI,光线B样形状和三阴性IHC形状有关.
- 雌激素受体阳性和PR阳性状态与较低的死亡风险有关.
- IHC 概况的变化与较长的生存期相关 (p=0.050).
- 多变量分析确定了NACT前的III级和三阴性IHC特征 (NACT前和后) 作为较短寿命的独立预测因素.
结论:
- 新辅助化疗 (NACT) 可以明显改变侵袭性乳腺癌 (IBC) 的特征和关键生物标志物.
- 这些NACT后的变化显著影响患者的整体存活率 (OS).
- 建议在NACT后的残留样本上重新评估瘤生物标志物,以改进治疗策略并改善患者的治疗结果.
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