| Objective To analyze the histological changes,clinical features and prognosis of breast carcinoma after neoadjuvant chemotherapy,to investigate the correlation between different histological changes of the tumor after neoadjuvant chemotherapy and the clinical features and prognosis of the patients.Methods The clinical data of 94 cases of breast carcinoma in Lanzhou General Hospital of Lanzhou Military Area Command from June 2011 to December 2014 were collected(The patients were diagnosed with primary invasive breast carcinoma and underwent surgical resection after neoadjuvant chemotherapy),at the same time,to find the first biopsy and neoadjuvant chemotherapy after resection of the tissue sections and paraffin wax.After the observation under the microscope,immunohistochemical staining of incomplete tissue,2 senior pathologists were invited to evaluate the residual tumor after neoadjuvant chemotherapy and divided into Grade 0,Grade 1 and Grade 2 according to the standard of efficacy evaluation of neoadjuvant chemotherapy in Anderson Carcinoma Center(Grade 0: there were no infiltrating tumor in the tumor and surrounding tissue;Grade 1: there were less than 5% invasive tumor components in the tumor and surrounding tissues;Grade 2 Grade: there were more than 5% invasive residual tumor in the tumor and surrounding tissue).We followed up patients to understand their survival.By statistical method,analyze the histological changes,clinical features and prognosis of breast carcinoma after neoadjuvant chemotherapy,Objective to investigate the differences of different histological changes in patients with breast carcinoma after neoadjuvant chemotherapy,and to analyze the factors influencing the prognosis of patients with breast carcinoma after neoadjuvant chemotherapy.Results 1.The two years progression free survival rates of patients who treated with AC+T chemotherapy regimens,FAC+T chemotherapy regimens and combined with chemotherapy Herceptin are 89.3%,90.6%,and 100%,respectively,and the three years progression free survival rates of patients were 84.6%,88.2%,and 100,respectively.2.The patients who accepted combined with chemotherapy Herceptin had a higher two years progression free survival rate than the patients who were treated with AC+T or FAC+T chemotherapy regimens.Among patients treated with AC+T chemotherapy regimens,The tumor was discovered to treatment time less than 24 months,had a higher two or three years progression free survival rate.3.In Grade 0,Grade 1 and Grade 2 the two years progression free survival rates of patients were 97.4%?75.0%,and 88.6%,respectively,and the three years progression free survival rates of patients were 92.9%?80.0%,and 86.4%,respectively.4.There was a significant difference between Grade 0 and Grade 1 patients in two years PFS(P=0.025).In Grade 0,the molecular subtypes of patients were associated with two years of PFS(P=0.033);in Grade 1,the size of the tumor after NAC was correlated with the patients' two-year PFS(P=0.046);in Grade 2,the patients' skin changes at the time of treatment were associated with the patients' PFS for two or three years(P=0.032,P=0.010);but none of them could be used as a predictor of progression free survival.5.In Grade 0,the main sites were necrosis,hyperplasia and carcinoma in situ residued the patients' two years progression free survival rates were 100% ? 95.5%,and 100%,respectively,and the patients' three years progression free survival rates were all 100%.6.In Grade 0,there was no significant difference between the different chemotherapy regimens in patients with different histological changes(P>0.05);in the proliferative group,the molecular subtype of patients was associated with the patients' two-year PFS(P=0.036),but it can not be used as a predictor of progression free survival in two years.Conclusion 1.The patients who accepted combined with chemotherapy Herceptin had a higher two years progression free survival rate than the patients who are treated with AC+T or FAC+T chemotherapy regimens.Among patients treated with AC+T chemotherapy regimens,the tumor is discovered to treatment time less than 24 months,has a higher two or three years progression free survival rate.2.Among the patients with different histological changes,there is a significant difference of PFS between Grade 0 and Grade 1;molecular subtypes in Grade 0,the size of the tumor after chemotherapy in Grade 1,the treatment of skin changes in Grade 2 can not bu used as predictors of progression free survival of the disease factors.3.In the proliferative group of Grade 0,the molecular subtype of patients is associated witthe patient's two-year PFS,but it can not be used as a predictor of progression free survivain two years. |
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