三阴性乳腺癌新辅助化疗后组织中Ki-67表达变化及其与疗效和预后的相关性

The Ki-67 expression change after neoadjuvant chemotherapy in triple negative breast cancer and the correlation with efficacy and prognosis

目的:探讨三阴性乳腺癌(triple negative breast cancer,TNBC)新辅助化疗(neoadjuvant chemotherapy,NAC)后组织中Ki-67表达变化及其与疗效和预后的相关性。方法:选取我院2013年01月至2018年01月经病理确诊为TNBC的患者70例,根据免疫组化法检测NAC后组织中Ki-67表达的变化,并根据Ki-67的表达变化将患者分为三组,分别为:低表达转为高表达组、表达无变化组和高表达转为低表达组,对比三组患者NAC的疗效,并应用Kaplan-Meier法绘制三组患者的生存曲线进行生存分析。结果:NAC后49例患者达到临床缓解,27例患者达到病理完全缓解(pathological complete response,pCR)。NAC后高表达转为低表达组可获得较好的临床缓解率及pCR率,三组患者的比较结果显示差异具有明显统计学意义(P<均0.05)。无病生存率(disease free survival,DFS)在低表达转为高表达组、表达无变化组及高表达转为低表达组中的差异具有明显统计学意义(P=0.001);三组患者的OS比较结果显示差异无明显统计学意义(P=0.085)。结论:TNBC患者NAC后组织中Ki-67的表达可发生改变,Ki-67表达降低的患者可能具有较好的疗效及预后。

Objective:To investigate the relationship between the expression of Ki-67 and the efficacy and prognosis of neoadjuvant chemotherapy in triple negative breast cancer.Methods:We selected 70 cases of patients with TNBC from January 2013 to January 2018.Immunohistochemical method was used to detect the changes of the expression of Ki-67 of the NAC.According to the expression of Ki-67 change,the patients were divided into three groups,including low to high expression group,expression unchanged group and high to low expression group.Clinical pathology reaction of three groups of patients with NAC.Kaplan-Meier analysed survival curve.Results:49 patients achieved clinical remission after NAC.27 patients achieved pathological complete response(pCR).After NAC high to low expression group could obtain better clinical remission rate and pCR rate.The comparison results of the three groups showed that the differences were statistically significant(P<0.05).The DFS in the low to high expression group,expression unchanged group and the high to low expression group,with statistically significant differences(P=0.001).There was no statistically significant difference in the comparison results of OS among the three groups(P=0.085).Conclusion:TNBC patients after NAC can change the expression of Ki-67,and patients with reduced Ki-67 expression may have better efficacy and prognosis.