The Relationship between Pathological Effect and Microvessel Density after Neoadjuvant Intraarterial Chemotherapy in Patients with Breast Cancer<?xml:namespace prefix = o ns = "urn:schemas-microsoft-com:office:office" />

黄　伟*  曹建民*  李成朗*

陈自谦*  许　健*

吴 波#

南京军区南京总医院， 210002

*医学影像科

#病理科

Wei Huang， Bo Wu， Jianmin Cao， et. al

Nanjing General Hospital of Nanjing Military. 210002

ABSTRACT

Objective:  to confirm the effect of neoadjuvant intraarterial chemotherapy in breast cancer and the change of microvessel density(MVD). and to find the relationship between pathological response and MVD.

Methods: The CEF chemotherapy was taken in 86 patients by intraarterial infusion chemotherapy. The interval between chemotherapy and surgery was average 8 days (1～27 days). Immunostaining was performed with the CD34 monoclonal antibody. The effect of chemotherapy in breast cancer was classified as no effect， effect， obvious effect， and specific effect.

Results: 79 (91.86%) were assessable for pathologic response. seven cases had no histological change. The median count of the patients with neoadjuvant intraarterial chemotherapy was 110.063/mm2 (95% confidence interval [CI]， 98.426～131.514/mm2) and the median count of the patient without neoadjuvant intraarterial chemotherapy was 196.256/mm2 (95% CI， 162.315～225.671/mm2) (P=0.033). The median count of MVD was lower with the effect increasing， but this was no statistically significant (P>0.05).

Conclusions: Neoadjuvant intraarterial chemotherapy in breast cancer can led to a well pathological response and cause a reduction in microvessel density. There is little relationship between the changes of microvessel density and pathological effect.

Key words: Breast neoplasms/drug therapy; Infusions， Intra-arterial; Breast neoplasms/pathology; Breast neoplasms/radiography

动脉灌注化疗作为化疗的方法之一，由于其具有局部药物浓度高，药物的首过效应、再循环效应和全身毒副作用小而广泛应用于恶性肿瘤的治疗中。多项对比研究已证实动脉灌注化疗的疗效要好于静脉化疗。特别是对于新辅助化疗来说，动脉灌注化疗可明显缩短等待手术的时间。本研究通过对86例乳腺癌动脉灌注化疗后病理疗效和微血管计数变化的分析，探讨新辅助动脉灌注化疗在乳腺癌治疗中的作用。

材料和方法

一、临床资料

86例研究对象为准备行手术治疗的乳腺癌住院患者，均为女性，年龄28～66岁(平均46)岁；临床TNM分期Ⅰ期8例、ⅡA期19例、ⅡB期29例，ⅢA期21例，ⅢB期9例。按照随机数字区组法选取50例术前未经化疗的患者，作为对照组; 实施动脉灌注化疗和未实施化疗两组患者的年龄、月经状况、肿瘤大小、淋巴结转移、ER、PR和PCNA均相似。所有病例均进行了术前乳腺肿瘤细针穿刺细胞学或肿瘤切取病理活检证实为原发性浸润性乳腺导管癌。化疗和手术间隔时间平均为8d。术后两组患者均进行了静脉辅助化疗。