筛选乳腺癌新辅助化疗敏感指标的临床研究

The study of screening sensitive indexes of predicting the curative effects of neoadjuvant chemotherapy in treatment of breast cancer

目的探讨新辅助化疗前乳腺癌患者ER、PR、Ki-67、C-erb B-2、VEGF、DBC2表达状态与新辅助化疗疗效的关系。方法选择Ⅱb~Ⅲc期行新辅助化疗的初治乳腺癌患者45例,采用免疫组织化学法检测化疗前及术后ER、PR、Ki-67、C-erb B-2、VEGF、DBC2的表达情况。结果单因素分析发现ER、PR表达阴性及Ki-67、VEGF高表达时,新辅助化疗病理完全缓解率及MP分级4~5级化疗反应比例分别高于ER、PR表达阳性及Ki-67、VEGF低表达时,差异有统计学意义(P<0.05)。结论 ER、PR表达阴性,Ki-67、VEGF高表达对新辅助化疗更敏感,可做为新辅助化疗疗效的预测因子。

Objective To investigate the expressions of ER,PR,Ki-67,C-erb B-2,VEGF,DBC2 before neoadjuvant chemotherapy in patients with breast cancer,and to explore the correlation between their expression levels and curative effects of neoadjuvant chemotherapy（ NAC）. Methods Forty-five patients with breast cancer at stage Ⅱ b ~ Ⅲ c who received neoadjuvant chemotherapy were enrolled in the study. The expression levels of ER,PR,Ki-67,C-erb B-2,VEGF and DBC2 were detected by immunohistochemistry before and after neoadjuvant chemotherapy. Results The univariate analysis showed that when the expressions of ER and PR were negative and Ki-67 and VEGF were highly expressed,the pathological complete remission rate after neoadjuvant chemotherapy and the proportion of chemotherapy reaction of grade 4 ~ 5（ MP classification）were significantly higher than those when the expressions of ER and PR were positive and Ki-67 and VEGF were lowly expressed,respectively（ P 〈0. 05）. Conclusion The breast cancer patients with negative expressions of ER and PR and high expressions of Ki-67 and VEGF are more sensitive to NAC,thus,which may be regarded as predictive indexes of NAC.