OBJECTIVE The breast cancer lack of expression of estrogenreceptor (ER), progesterone receptor (PR), and human epidermalgrowth factor receptor 2 (HER-2) is defined as the Triple-negativebreast cancer (TNBC). Our purpo...OBJECTIVE The breast cancer lack of expression of estrogenreceptor (ER), progesterone receptor (PR), and human epidermalgrowth factor receptor 2 (HER-2) is defined as the Triple-negativebreast cancer (TNBC). Our purpose is to compare the responseand long-term effect of the TNBC and non-TNBC patientsreceiving neo-adjuvant anthracycline-based chemotherapy, and toinvestigate the mechanisms of TNBC affecting the survivals.METHODS Data of long-term follow-up (median, 5.4 years)of 326 patients who received neo-adjuvant chemotherapy withanthracycline-based regimen, during a period from 2000 to 2003,were analyzed. Expressions of ER, PR, HER-2, P53, Ki-67 andE-cadherin were determined using immunohistochemical stainingmethod. A multivariate Cox regression analysis was used toanalyze independent prognostic factors affecting the relapse-freesurvival (RFS) and overall survival (OS) rates. Clinical effects ofthe neo-adjuvant anthracycline-based chemotherapeutic regimenand the RFS and OS rates were compared between the patientswith TNBC and non-TNBC, and the correlations among the triple-negative phenotype (TNP), tumor grading and the expressions ofP53, Ki-67 and E-cadherins were analyzed.RESULTS TNP, TNM staging, histological grades, clinicalresponse of the neo-adjuvant chemotherapy and pathologicalcomplete remission (pCR) rate were the independent prognosticfactors affecting the survival rates. Furthermore, 70 (21.5%) of the326 patients suffered TNBC. Compared with the subjects in non-TNBC group, the patients with TNBC had a significantly higherpCR rate (P = 0.046) and clinical response rate (P = 0.037), but alsodecreased 5-year RFS (P = 0.001) and OS (P = 0.004) rates. TheRFS and OS rates were not improved in the TNBC patients whoachieved a clinical remission after the neo-adjuvant chemotherapy.The triple-negative phenotype was positively correlated with thelevel of P53, Ki-67 expression (P = 0.007, P = 0.028), but negativelycorrelated with level of E-cadherin (P = 0.034).CONCLUSION Both clinical remission rate and pCR rate ofthe TNBC patients receiving neo-adjuvant anthracycline-basedchemotherapy are high, however, the long-term effect is poor.The mechanism may relate to a strong potential of proliferationand invasive metastasis, as well as lack of an effective therapeutictarget in the TNBC patients.展开更多
文摘OBJECTIVE The breast cancer lack of expression of estrogenreceptor (ER), progesterone receptor (PR), and human epidermalgrowth factor receptor 2 (HER-2) is defined as the Triple-negativebreast cancer (TNBC). Our purpose is to compare the responseand long-term effect of the TNBC and non-TNBC patientsreceiving neo-adjuvant anthracycline-based chemotherapy, and toinvestigate the mechanisms of TNBC affecting the survivals.METHODS Data of long-term follow-up (median, 5.4 years)of 326 patients who received neo-adjuvant chemotherapy withanthracycline-based regimen, during a period from 2000 to 2003,were analyzed. Expressions of ER, PR, HER-2, P53, Ki-67 andE-cadherin were determined using immunohistochemical stainingmethod. A multivariate Cox regression analysis was used toanalyze independent prognostic factors affecting the relapse-freesurvival (RFS) and overall survival (OS) rates. Clinical effects ofthe neo-adjuvant anthracycline-based chemotherapeutic regimenand the RFS and OS rates were compared between the patientswith TNBC and non-TNBC, and the correlations among the triple-negative phenotype (TNP), tumor grading and the expressions ofP53, Ki-67 and E-cadherins were analyzed.RESULTS TNP, TNM staging, histological grades, clinicalresponse of the neo-adjuvant chemotherapy and pathologicalcomplete remission (pCR) rate were the independent prognosticfactors affecting the survival rates. Furthermore, 70 (21.5%) of the326 patients suffered TNBC. Compared with the subjects in non-TNBC group, the patients with TNBC had a significantly higherpCR rate (P = 0.046) and clinical response rate (P = 0.037), but alsodecreased 5-year RFS (P = 0.001) and OS (P = 0.004) rates. TheRFS and OS rates were not improved in the TNBC patients whoachieved a clinical remission after the neo-adjuvant chemotherapy.The triple-negative phenotype was positively correlated with thelevel of P53, Ki-67 expression (P = 0.007, P = 0.028), but negativelycorrelated with level of E-cadherin (P = 0.034).CONCLUSION Both clinical remission rate and pCR rate ofthe TNBC patients receiving neo-adjuvant anthracycline-basedchemotherapy are high, however, the long-term effect is poor.The mechanism may relate to a strong potential of proliferationand invasive metastasis, as well as lack of an effective therapeutictarget in the TNBC patients.
