【摘要】 目的 探讨老年性乳腺癌术前内分泌治疗效果及降期后手术优点。 方法 2004年5月－2010年12月19例老年性局部晚期乳腺癌患者，术前给予口服芳香化酶抑制剂（aromatase inhibitors，AI）2～10个月，进行疗效观察，降期后手术及术后同一有效内分泌药物继续治疗并随访，时间1～66个月。 结果 自AI治疗开始至手术时，临床完全缓解2例，部分缓解11例，稳定3例，进展3例；手术14例，另5例由于全身状况差、基础疾病严重不能耐受手术或局部进展而放弃手术，5年总生存率68%，无瘤生存率47%。 结论 术前内分泌治疗疗效可靠，不良反应轻，特别适应老年伴有内科疾病不适应化学疗法的患者，可以增加保乳手术率和手术切除率。【Abstract】 Objective To investigate the clinical value of neo-adjuvant endocrine therapy for locally advanced breast cancer in elderly patients and the advantages of operation after down-staging of breast cancer. Methods From May 2004 to December 2010, 19 patients with locally advanced breast cancer were treated with Aromatase inhibitor (AI) neo-adjuvant endocrine therapy for 2 to 10 months before operation. The clinical efficacy was observed. Operation was performed after down-staging of the cancer. After the operation, patients continued taking the same effective drug and were followed-up for 1 to 66 months. Results From AI treatment to the time of operation, there were 2 cases of clinical complete response, 11 cases of clinical partial response, 3 cases of stable disease, and 3 cases of progressive disease. A total of 14 patients were operated, and 5 other patients could not have the operation for bad body conditions, serious basic-diseases or local progress of the disease. The 5-year overall survival rate was 68%, and the disease-free survival rate was 47%. Conclusion Neo-adjuvant endocrine therapy has a reliable clinical effect and low side-effects. It is especially suitable for elderly patients excluded from chemotherapy because of internal medical diseases. It can also increase the rate of breast-conserving and surgical excision.
ObjectiveTo investigate the relationship between the polymorphisms of estrogen receptor α (ERα) gene PvuⅡ, XbaⅠ and breast hyperplasia. MethodsPolymerase chain reaction-restriction fragment length polymorphism was used to detect the polymorphisms of ERα gene PvuⅡ, XbaⅠ in breast hyperplasia patients (study group, n=89) and healthy controls (control group, n=35). ResultsThe differences of the genotypic frequency and allele frequency of the ERα gene Xba Ⅰ were significant between the study group and the control group (Plt;0.05). According to analysis of the odds ratio (OR), the risk of developing breast hyperplasia for X allele carriers was 0.551 as compared with x allele carriers. But there was no significant difference for the gene polymorphism of PvuⅡ between the study group and the control group (Pgt;0.05). ConclusionThe polymorphisms of XbaⅠof ERα gene is associated with breast hyperplasia and the mutant gene increases breast hyperplasia risk.