摘 要
乳腺癌是全球女性发病率最高的恶性肿瘤之一，新辅助化疗作为局部晚期乳腺癌的重要治疗手段，其疗效评估对制定后续治疗方案至关重要。本研究旨在系统梳理和分析当前乳腺癌新辅助化疗疗效评估指标的研究进展，为临床实践提供理论依据。通过对国内外相关文献的广泛检索与分析，结合临床试验数据，重点探讨了影像学评估、病理学评估及生物标志物检测等多维度评估体系。研究发现，传统影像学检查如超声、磁共振成像虽能直观反映肿瘤大小变化，但存在主观性强、特异性不足等问题；而以病理完全缓解率为代表的病理学评估则更准确地反映了治疗效果，成为目前公认的金标准。近年来，随着分子生物学技术的发展，循环肿瘤细胞、微小残留病灶等新型生物标志物展现出良好应用前景，可实现早期预测和动态监测。本研究创新性地提出了整合多模态评估体系的概念，强调将不同评估方法有机结合，以提高评估准确性并指导个体化治疗方案的选择，为优化乳腺癌新辅助化疗疗效评估提供了新的思路和方向，有助于推动精准医学在乳腺癌领域的应用与发展。
关键词：乳腺癌新辅助化疗；疗效评估；病理完全缓解率；生物标志物；多模态评估体系
Abstract
Breast cancer is one of the most prevalent malignant tumors among women globally. Neoadjuvant chemotherapy serves as a crucial therapeutic approach for locally advanced breast cancer, and its efficacy evaluation is essential for formulating subsequent treatment plans. This study aims to systematically review and analyze the research progress on evaluation indicators of neoadjuvant chemotherapy efficacy in breast cancer, providing theoretical support for clinical practice. By extensively searching and analyzing relevant literature both domestically and internationally, combined with clinical trial data, this study focuses on multidimensional evaluation systems including radiological assessment, pathological assessment, and biomarker detection. It was found that traditional imaging examinations such as ultrasound and magnetic resonance imaging can intuitively reflect changes in tumor size but suffer from issues like high subjectivity and insufficient specificity; whereas pathological assessments represented by pathologic complete response rate more accurately reflect treatment outcomes and are currently recognized as the gold standard. In recent years, with the development of molecular biology techniques, novel biomarkers such as circulating tumor cells and minimal residual disease have shown promising application prospects, enabling early prediction and dynamic monitoring. Innovatively, this study proposes the concept of integrating multimodal evaluation systems, emphasizing the organic combination of different evaluation methods to enhance accuracy and guide personalized treatment selection. This provides new insights and directions for optimizing the efficacy evaluation of neoadjuvant chemotherapy in breast cancer and contributes to the application and development of precision medicine in this field.
Keywords：Neoadjuvant Chemotherapy For Breast Cancer；Efficacy Evaluation；Pathological Complete Response Rate；Biomarkers；Multimodal Evaluation System
目 录
摘 要 I
Abstract II
引 言 1
第一章 乳腺癌新辅助化疗概述 2
1.1 新辅助化疗定义与意义 2
1.2 新辅助化疗发展历程 2
1.3 新辅助化疗临床应用现状 3
第二章 疗效评估的传统指标研究 5
2.1 肿瘤大小变化分析 5
2.2 淋巴结状态评价 5
2.3 组织学反应评估 6
第三章 新型疗效评估指标探索 7
3.1 分子标志物的应用进展 7
3.2 影像学技术的新发展 7
3.3 循环肿瘤细胞检测 8
第四章 疗效评估体系的优化方向 9
4.1 多学科综合评估模式 9
4.2 个性化治疗效果预测 9
4.3 长期预后指标构建 10
结 论 12
参考文献 13
致 谢 14
