CerbB-2、P53和Ki-67表达与乳腺癌新辅助化疗敏感性的关系

The relationship between the expression of CerbB-2, P53 and Ki-67 and the chemotherapy effect of breast cancer FEC/CET regimen

目的探讨乳腺癌组织中表皮因子受体2(Cerb B-2)、P53及Ki-67蛋白的表达与患者新辅助化疗敏感性的关系。方法选取117例临床资料完整的乳腺癌患者进行回顾性分析,病例收集时间2013年2月至2016年4月,所有患者均接受FEC(5-氟尿嘧啶+表阿霉素+环磷酰胺)或CET(环磷酰胺+表阿霉素+多西紫杉醇)方案新辅助化疗,患者完成2~6个疗程后实施根治性手术治疗,采用免疫组化染色检测化疗前患者的Cerb B-2、P53及Ki-67蛋白表达水平,并根据化疗效果分为敏感组、非敏感组进行相关性分析。结果 117例乳腺癌患者中Cerb B-2、P53、Ki-67蛋白阳性率分别为36.75%、47.01%、65.81%,Cerb B-2蛋白阳性患者新辅助化疗敏感率为51.16%,低于蛋白阴性表达患者的81.08%;Ki-67蛋白阳性新辅助化疗敏感率为77.92%,高于蛋白阴性患者的55.00%,差异均有统计学意义(P<0.05);P53蛋白阳性表达与患者新辅助化疗敏感性无关(P>0.05);乳腺癌患者组织学分级增高、临床分期增高、Cerb B-2蛋白阳性表达、Ki-67蛋白阴性表达会降低患者新辅助化疗的敏感性(P<0.05)。结论根据乳腺癌组织中Cerb B-2及Ki-67蛋白表达情况可以判断患者新辅助化疗的敏感性。

Objective To investigate the relationship between the expression of epidermal factor receptor 2（CerbB-2）,P53 and Ki-67 protein in breast cancer and the sensitivity of neoadjuvant chemotherapy in patients with breast cancer.Methods A total of 117 patients with complete clinical data were retrospectively analyzed. Patients were collected fromFebruary 2013 to April 2016. All patients underwent FEC（5-FU ＋ epirubicin ＋ cyclophosphamide） or CET regimen（cyclophosphamide＋epirubicin＋docetaxel）neoadjuvant chemotherapy;after completed 2 to 6 courses,radical surgery wasimplemented for complete cure. Immunohistochemical staining was used to detect the expression of CerbB-2,P53 and Ki-67 protein in patients before chemotherapy. According to the effect of chemotherapy,the patients were divided into sensitivegroup and non-sensitive group for correlation analysis. Results Among the 117 breast cancer patients,the positive rate ofCerbB-2 protein was 36.75%,the positive rate of P53 protein was 47.01%,and the positive rate of Ki-67 protein was65.81%. The sensitive rate of neoadjuvant chemotherapy was 51.16% in CerbB-2 protein positive patients,which was lowerthan that of CerbB-2 protein negative patients（81.08%）;the sensitive rate of neoadjuvant chemotherapy was 77.92% in Ki-67 protein positive patients,which was higher than that of Ki-67 protein negative patients（55.00%）;The difference wasstatistically significant（P〈0.05）. There was no correlation between the positive expression of P53 protein and the sensitivityof neoadjuvant chemotherapy（P〉0.05）. The histological grade and the clinical stage of breast cancer patients increased,andthe positive expression of CerbB-2 protein,the negative expression of Ki-67 protein decreased the sensitivity of neoadjuvantchemotherapy（P〈0.05）. Conclusion According to the expression of CerbB-2 and Ki-67 protein in breast cancer tissues,the sensitivity of neoadjuvant chemotherapy could be judged.