Ki-67的改变与Ⅱ-Ⅲ期浸润性乳腺癌患者化疗疗效之间的关系

Relationship between Ki-67 and the chemotherapy effect of phraseⅡ-Ⅲ invasive breast cancer

目的探讨增殖细胞核抗原（Ki-67）与Ⅱ-Ⅲ期浸润性乳腺癌患者新辅助化疗疗效的关系。方法选取宁波市第二医院乳腺外科收治的89例初治Ⅱ-Ⅲ期浸润性乳腺癌患者作为研究对象,新辅助化疗前通过穿刺取癌组织进行免疫组化染色,3 w新辅助化疗完成后进行乳腺癌根治性手术治疗,取手术后癌组织行免疫组化染色,对比不同Ki-67的表达水平与患者化疗近期效果的关系,并分析化疗效果与患者的临床病理特征的关系。结果化疗前,Ki-67高表达患者52例,低表达37例,高表达患者的缓解率63.46%显著的高于低表达组患者的35.13%（P〈0.05）;化疗后Ki-67的高表达率38.20%显著低于化疗前的58.43%（P〈0.05）;采用Logistic模型分析,结果显示淋巴结转移、临床分期Ⅲ期、MP分级3＋4级、Ki-67低表达降低缓解率（P〈0.05）。结论 Ki-67与Ⅱ-Ⅲ期浸润性乳腺癌患者新辅助化疗疗效关系密切,可以作为临床上术前辅助化疗效果评估的参考指标。

Objective To investigate the relationship between Ki-67 and the chemotherapy effect of phraseⅡ-Ⅲ invasive breast cancer. Methods89 cases phraseⅡ-Ⅲ invasive breast cancer patients enrolled into our hospital were collected through biopsy and immunohistochemically stained. After 3weeks＇ neoadjuvant chemotherapy,cancer tissue were taken by surgery. The expression of Ki-67 before and after chemotherapy were compared.Results Before chemotherapy,52 patients with Ki-67 high expression had 63. 64% response rate,which were higher than 35. 13% in 37 cases with Ki-67 low expression（P〈0. 05）. After chemotherapy,high Ki-67 expression decreased from 58. 43% to 38. 20%（P〈0. 05）. Logistic model analysis showed： lymphatic metastasis,phase Ⅲ,MP histological grade（grade 3-4） would decrease the remission rate（P〈0. 05）. Conclusion Ki-67 is closely related with the chemotherapy effect of phraseⅡ-Ⅲ invasive breast cancer,which can be a clinical reference for preoperative adjuvant chemotherapy.