乳腺癌新辅助化疗对癌组织ER、PR、HER-2及Ki67水平的影响

Effects of neoadjuvant chemotherapy for breast cancer on the levels of ER,PR,HER-2 and Ki67 in cancer tissues

目的探讨乳腺癌新辅助化疗对癌组织雌激素受体(ER)、孕激素受体(PR)、人表皮生长因子受2(HER-2)及Ki67水平的影响。方法回顾性选取西中医药大学附属西电集团医院普外科收治的85例初诊乳腺癌患者为研究对象,经空心针穿刺活检确诊,均接受乳腺癌手术,术前接受新辅助化疗,观察化疗疗效,采用免疫组化染色法检测化疗前后ER、PR、HER-2及Ki67的表达情况,并分析标记物表达变化与化疗疗效的关系。结果 85例乳腺癌患者经新辅助化疗后,完全缓解4例(4. 71%),部分缓解62例(72. 94%),疾病稳定14例(16. 47%),疾病进展5例(5. 88%);术后病理完全缓解(p CR) 8例(9. 41%)。化疗前后ER、PR、HER-2表达情况比较,差异无统计学意义(P> 0. 05);化疗后Ki67阳性表达率明显低于化疗前(P <0. 05); Ki67表达阳性患者与阴性患者在化疗疗效方面存在显著差异(P<0. 05)。Spearman相关性分析显示,Ki67表达变化与化疗疗效呈负相关(r=-0. 563,P <0. 05)。结论乳腺癌术前新辅助化疗可有效控制肿瘤,降低Ki67的表达水平,Ki67可作为乳腺癌分子标记物,但新辅助化疗不能显著影响ER、PR、HER-2的表达水平。

Objective To explore the effects of neoadjuvant chemotherapy for breast cancer on the levels of estrogen receptor(ER),progesterone receptor(PR)and human epidermal growth factor 2(HER-2)and Ki67 in cancer tissues.Methods 85 cases of patients with newly diagnosed breast cancer admitted to department of surgery of Xian Dian Group Hospital Affiliated to Shaanxi University of Chinese Medicine were selected for the study.The patients were diagnosed by hollow needle biopsy as breast cancer surgery,and they were given neoadjuvant chemotherapy before operation.The chemotherapy efficacy was observed.Immunohistochemistry staining was used to detect the expressions of ER,PR,HER-2 and Ki67 before and after chemotherapy,and the relationship between expression of markers and efficacy of chemotherapy was analyzed.Results Among the 85 patients with breast cancer who underwent neoadjuvant chemotherapy,there were 4 cases(4.71%)of complete remission,62 cases(72.94%)of partial remission,14 cases(16.47%)of stable disease,and 5 cases(5.88%)of disease progression.There were 8 cases(9.41%)with pathological complete remission(pCR)after operation.There were no significant differences in the expression levels of ER,PR and HER-2 before and after chemotherapy(P>0.05).The positive expression rate of Ki67 after chemotherapy was significantly lower than that before chemotherapy(P<0.05).There was a significant difference in the chemotherapy efficacy among patient with positive Ki67 and negative Ki67(P<0.05).Spearman correlation analysis showed that Ki67 expression was negatively correlated with chemotherapy efficacy(r=-0.563,P<0.05).Conclusion Neoadjuvant chemotherapy before breast cancer surgery can effectively control tumors and reduce the expression level of Ki67.Ki67 can be used as a molecular marker for breast cancer.