乳腺癌新辅助化疗前后相关生物因子的变化及MP分级相关预测因子分析

Changes of related biological factors before and after neoadjuvant chemotherapy for breast cancer and analysis of related predictors of MP grading

目的研究乳腺癌相关生物学因子的表达在新辅助化疗中是否发生变化,并针对此变化探究其临床意义;对于乳腺癌新辅助化疗后Miller-Payne分级情况是否与生物因子的表达有关进行分析,为预测不同患者行新辅助化疗后产生怎样的效果提供思考方向。方法收集本院自2019年1月一2021年5月收治的接受新辅助化疗的亂腺癌患者68例,所有患者术前均行新辅助化疗,化疗前后采用免疫组织化学染色检测ER、PR、Her-2及Ki-67的表达,分析其是否有明显的升高或下降;化疗后行病理Miller-Payne分级评估,分析Miller-Payne分级与化疗前ER、PR、Her-2及Ki-67的表达是否有关。结果68例患者新辅助化疗前Ki-67的阳性率为65.9%,化疗后阳性率降至34.1%,差异有统计学意义(P<0.05)。新辅助化疗后Miller-Payne分级达到G5患者有15例(22.1%),G5与G1~G4患者间Her-2表达有统计学意义(P<0.05);经二元Logistic回归分析,Her-2的阳性表达是乳腺癌新辅助化疗后Miller-Payne分级(G5)的一项预测指标[P<0.05,OR=0.214,95%CI(0.056~0.816)]。结论乳腺癌患者新辅助化疗前后相比,Ki-67表达显著降低,为临床化疗疗效的评估提供参考;Her-2阳性可作为乳腺癌新辅助化疗后M iller-Payne分级(G5)的预测因子。

Objective:To study whether the expression of biological factors is related to breast cancer changes during neoadjuvant chemotherapy,and to explore the clinical significance of such changes.To analyze whether the Miller-Payne grading of breast cancer after neoadjuvant chemotherapy is related to the expression of biological factors,so as to provide ideas for predicting the effects of neoadjuvant chemotherapy in different patients.Methods:All 68 cases who accepted the preoperative neoadjuvant chemotherapy of breast cancer in our hospital from January 2019 to May 2021 were collected in this analysis.Significant changes of the expression of the endoplasmic reticulum ER,PR,Her-2,Ki-67 before and after the neoadjuvant chemotherapy were analyzed by the immunohistochemistry.Pathological Miller-Payne grading system evaluation was performed after chemotherapy,and the relationship between Miller-Payne grading system and the expression of biological factors ER,PR,Her-2 and Ki-67 in breast cancer before chemotherapy was analyzed.Results:The positive rate of Ki-67 in 68 patients decreased to 34.1%after neoadjuvant chemotherapy compared with the prior 65.9%,which is statistically significant(P<0.05).15(22.1%)patients had a grade 5(G5)response after the neoadjuvant chemotherapy.There was a statistical difference in the expression of Her-2 between the G5 and G1〜4 groups(P<0.05).The results of the logistic regression analysis showed that the positive expression of Her-2 was a predictor for G5 in breast cancer treated with neoadjuvant chemotherapy[P<0.05,OR=0.214,95%CZ(0.056〜0.816)].Conclusion:The expression of Ki-67dose is significantly lowered in breast cancer patients after neoadjuvant chemotherapy,which can be used as a sensitive index for clinical chemotherapy evaluation.The positive expression of Her-2 can be used as a predictor of Miller-Payne grading(G5)in breast cancer patients treated with neoadjuvant chemotherapy.