乳癌新辅助化疗后Ki-67变化与临床疗效的关系

RELATIONSHIP BETWEEN KI-67 EXPRESSION AND CLINICAL OUTCOME IN BREAST CANCER AFTER NEOADJUVANT CHEMOTHERAPY

目的探讨乳癌病人新辅助化疗后Ki-67的表达变化与临床疗效的关系。方法选取Ⅱ~Ⅲ期的女性乳癌病人112例,术前均接受新辅助化疗。采用万科真空辅助旋切系统取样,应用免疫组化法检测新辅助化疗前后Ki-67的表达,分析其表达变化与临床疗效的关系。结果乳癌病人新辅助化疗前Ki-67的高表达率为80.4%,低表达率为19.6%;新辅助化疗后Ki-67的高表达率为26.8%,低表达率为73.2%,新辅助化疗前后Ki-67的表达比较差异有统计学意义(χ~2=64.62,P<0.05)。新辅助化疗的临床有效率为45.5%,临床获益率为84.8%。Ki-67高表达的病人对新辅助化疗敏感性较高,化疗后Ki-67的表达由高转为低的病人临床疗效较好,化疗后Ki-67的表达没有变化或者由低转为高的病人临床疗效较差,Ki-67的表达变化与临床疗效有关(χ~2=25.153,P<0.05)。结论 Ki-67表达很可能成为评估乳癌新辅助化疗效果的生物学指标,对化疗预后有提示作用。

Objective To investigate the association of expression of Ki-67 with clinical effectiveness in breast cancer after neoadjuvant chemotherapy（NC）. Methods One hundred and twelve female patients with stageⅡ-Ⅲ breast cancer were selected,and given a neoadjuvant chemotherapy before surgery.Samples were taken using EnCor vacuum assisted biopsy instrument,the expression of Ki-67-before and after NC-was detected employing immunohistochemistry,the association of Ki-67 with clinical efficacy was analyzed. Results Before NC,the high expression rate of Ki-67 was 80.4%,and the low of that was19.6%;after NC,the high expression of Ki-67 was 26.8%,and the low of that was 73.2%,the differences in Ki-67 expression rates-before and after NC-were statistically significant（χ^2=64.62,P〈0.05）.The clinical effective rate for NC was 45.5%,and the clinical benefit rate was 84.8%.Patients with high expression of Ki-67 were sensitive to NC,and the clinical efficacy was better in those with decline of Ki-67 after NC,and the efficacy was poor for those with no changes of Ki-67 after NC or Ki-67 raised from low to high,the changes of Ki-67 expression were related to clinical effectiveness（χ^2=25.153,P〈0.05）. Conclusion Ki-67 is likely to become a bioindicator in evaluation of neoadjuvant chemotherapy in breast cancer,which can predict the prognosis of the cancer after this kind of treatment.