三阴乳腺癌新辅助化疗的预后与Ki-67、TOPK的表达情况相关性研究

Study of Correlation of Ki-67,TOPK Expression of Neoadjuvant Chemotherapy in Triple-negative Breast Cancer with Prognosis

目的:研究三阴乳腺癌(TNBC)新辅助化疗(NACT)的预后与Ki-67、TOPK的表达情况的相关性。方法:回顾性收集2014年3月至2016年6月期间我院收治并行NACT的TNBC患者90例作为研究对象,免疫组化法检测肿瘤组织中Ki-67和TOPK的表达,分析两者的表达与患者临床资料的关系,应用COX回归模型进行生存分析,分析影响TNBC患者预后的独立危险因素。结果:在治疗情况方面,91.11%(82/90)的患者接受了≥4个周期的NACT治疗,84.44%(76/90)的患者接受了手术治疗,术后p CR为22.22%(20/90),ORR为75.56%(68/90)。为期5年的随访中,90例患者中共死亡8例(死于TNBC者6例,其他原因2例),失访2例;治疗后Ki-67和TOPK的阳性率均显著低于治疗前(P<0.05);Ki-67、TOPK阳性和阴性表达病例在不同TNM分期、淋巴结是否转移上具有显著性差异(P<0.05);Ki-67和TOPK阳性表达患者的无进展生存期(PFS)和总生存期(OS)显著短于阴性表达者(P<0.05);TNM分期、淋巴结转移、Ki-67和TOPK阳性表达均为影响TNBC患者预后的独立危险因素。结论:Ki-67和TOPK在TNBC组织中的表达与患者的病理学特征及预后密切相关,是影响预后的独立危险因素。

Objective: To analysis the correlation of Ki-67, TOPK expression of neoadjuvant chemotherapy(NACT) in triple-negative breast cancer(TNBC) with prognosis. Methods: 90 TNBC patients admitted in our hospital from March 2014 to June 2016 were collected as research objects, the expression of Ki-67 and TOPK in tumor tissues were detected by immunohistochemistry method, the correlation of Ki-67 and TOPK expression with pathological characteristics were analysed, the survival analysis were analyzed by Cox proportional hazards regression model rognosis, the independent risk factors for prognosis were analysed. Results: In terms of treatment, 91.11 %(82/90) of patients received ≥4 cycles of NACT, 84.44 %(76/90) of patients received surgery, and post-operative pCR was 22.22 %(20/90) and ORR was 75.56 %(68/90). During the 5-year follow-up, 8 of the 90 patients died(6 died of TNBC and 2 died of other causes),and 2 were lost to follow-up. The positive expression rates of Ki-67 and TOPK were decreased after NACT(P<0.05). There were significant differences between the positive and negative expression of KI-67 and TOPK in different TNM stages and lymph node metastasis(P<0.05). The progression-free survival(PFS) and overall survival(OS) of patients with Ki-67 and TOPK positive expression was shorter than negative expression(P<0.05). The prognosis of TNBC patients were independently associated with TNM stage, lymph node metastasis, positive expression of Ki-67 and TOPK(P<0.05). Conclusion: The expression of Ki-67 and TOPK in tissues was closely correlated with pathological characteristics and prognosis, which were independent risk fators for prognosis.