新辅助化疗对Ⅲ期非小细胞肺癌细胞凋亡和增殖的影响

目的：探讨新辅助化疗对非小细胞肺癌肿瘤细胞凋亡及对肿瘤细胞增殖的影响。方法：选取Ⅲ期非小细胞肺癌患者56例行新辅助化疗后并手术．并选取同期50例直接手术患者作为对照组。两组患者的手术标本．分别采用末端转移酶介导的dUTP切口末端标记法（TUNEL）行细胞凋亡检测，采用免疫组化标记链菌亲和素生物素法（LSAB），检测细胞增殖抗原Ki－67的表达。结果：新辅助化疗组肿瘤细胞凋亡指数（AI）均数为9．34％，对照组肿瘤细胞凋亡指数均数为5．27％．两组比较有显著差异（P〈0，001）。新辅助化疗组肿瘤细胞增殖抗原Ki－67阳性表达率均数为35．68％．对照组Ki－67阳性表达率均数为59.35％，两组比较差异显著（P〈0．001）。新辅助化疗组及对照组中，肿瘤细胞凋亡指数AI与增殖指数Ki-67的阳性表达均成负相关。结论：新辅助化疗能诱导Ⅲ期非小细胞肺癌肿瘤细胞的凋亡．并能抑制其增殖。     

新辅助化疗对乳腺癌细胞凋亡和增殖的影响

背景与目的：在实验研究中,已证实多种化疗药物都可引起乳腺癌细胞的凋亡。但在人体内进行有关化疗药物引起乳腺癌细胞凋亡的研究,还少有报道。本文研究新辅助化疗能否引起乳腺癌肿瘤细胞的凋亡以及对乳腺癌肿瘤细胞增殖的影响。方法：应用末端转移酶介导的dUTP切口末端标记法（TdT-mediated dUTP nick end labelling,TUNEL)及免疫组化的标记链菌亲和素生物素法（Labelled Streptavidin Biotin,LSAB),分别检测100例乳腺癌组织中肿瘤细胞的凋亡指数（Apoptotic index,AI)和乳腺癌肿瘤组织的增殖细胞核抗原（Proliferating cell nuclear antigen,PCNA)表达。结果：新辅助化疗组肿瘤细胞凋亡指数（AI）均数为7．47％,与对照组肿瘤细胞凋亡指数（AI）均数4．83％相比明显增高（P＜0．01）。新辅助化疗组肿瘤细胞增殖细胞核抗原（proliferation cell nuclear antigen,PCNA)阳性表达率均数为33．71％,与对照组PCNA阳性率均数51．52％相比明显降低（P＜0．01）。在新辅助化疗组及对照组两组病例中,肿瘤细胞凋亡指数（AI）与增殖细胞核抗原（PCNA）的阳性表达均呈负相关。结论：在人体乳腺癌组织中,新辅助化疗能诱导肿瘤细胞发生凋亡,并能抑制其增殖。     

乳腺癌新辅助化疗后细胞增殖与凋亡的变化及临床意义

目的：观察乳腺癌患者新辅助化疗前后细胞增殖及凋亡的变化，分析与化疗疗效的关系。方法：51例乳腺癌患者术前经Mammotome穿刺活检确诊，在CEF方案新辅助化疗前及化疗2个周期后分别进行癌组织中Ki-67的免疫组织化学染色和TUNEL原位细胞凋亡检测，并评价化疗疗效。结果：新辅助化疗前Ki-67阳性表达率及凋亡指数（AI）分别为23．2％和34．1％，化疗2个周期后Ki-67阳性表达率及A1分别为7．8％和67．5%，两者差异有统计学意义，P=0．004，P=0．006；化疗疗效临床CR5例，PR40例，SD6例，无疾病进展期病例，新辅助化疗疗效与Ki-67表达下降及肿瘤细胞凋亡增加显著相关。结论：新辅助化疗可明显抑制乳腺癌细胞的增殖，诱导凋亡，与化疗疗效密切相关。     

新辅助化疗后乳腺癌组织中survivin、Ki-67和 AI的表达及其临床意义

目的探讨新辅助化疗后乳腺癌组织中survivin、Ki-67和AI的表达及其临床意义。方法采用免疫组化SABC法,检测60例行新辅助化疗和60例未行新辅助化疗的乳腺癌组织中survivin和Ki-67的表达,采用原位细胞末端转移标记法(TUNEL法)检测细胞凋亡。结果新辅助化疗组survivin和Ki-67阳性率分别为36.7%和38.3%,明显低于对照组(71.7%,61.7%),P均<0.05;新辅助化疗组AI均数为(9.34±3.12)%,低于对照组(5.27±3.16)%,P<0.05;新辅助化疗组survivin的表达与AI呈负相关,而与Ki-67表达呈正相关。新辅助化疗组化疗总有效率为73.3%,化疗后部分缓解者(Ⅱ级)病例survivin阳性率(18.2%)明显低于无效者(Ⅲ级)(81.3%),P<0.01。结论CTF方案新辅助化疗,可能通过抑制乳腺癌survivin表达而抑制肿瘤的增殖和诱导其凋亡。     

新辅助化疗对乳腺癌肿瘤细胞的影响及其临床意义

目的:探索新辅助化疗对人体乳腺癌的作用机制及其临床应用的意义。方法:选取同期经病理确诊可手术的女性乳腺癌100例,分成新辅助化疗组和对照组各50例进行配对研究。新辅助化疗组术前接受CMF或CAF方案化疗2个疗程,对照组术前不接受任何抗肿瘤治疗。手术标本常规病理检查,同时应用原位末端标记法(TUNEL)及免疫组化LSAB法,分别检测乳腺癌组织中肿瘤细胞的凋亡指数(AI)和肿瘤组织的增殖细胞核抗原(PCNA)表达。结果:新辅助化疗组CR4例(8.0%),PR28例(56.0%),SD18例(36.0%),无恶化病例,总有效率为64.0%。新辅助化疗组AI(7.5%±2.9%),PCNA表达的阳性率(33.7%±6.8%);对照组AI(4.8%±2.1%),PCNA表达的阳性率(51.5%±10.2%)。AI与PCNA表达的阳性率均呈负相关,与化疗的疗效呈正相关。结论:乳腺癌新辅助化疗的总有效率(CR+PR)为64.0%;在人体乳腺癌组织中,新辅助化疗的作用机制除化疗药物的细胞毒作用外,还有可能通过诱导肿瘤细胞凋亡并抑制其增殖发挥抗肿瘤作用。     

局部进展期乳腺癌新辅助化疗前后生物标志物表达变化与疗效的相关性

目的：探讨局部进展期乳腺癌行新辅助化疗前后相关生物标志物的表达变化情况与化疗疗效的相关性。方法：采用免疫组化方法检测102例新辅助化疗前后局部进展期乳腺癌组织中雌激素受体（ER）、孕激素受体（PR）、人类表皮生长因子受体－2（HER －2）、p53和增殖细胞核抗原（Ki －67）等表达,分析化疗前后生物标志物表达变化与化疗疗效的相关性。结果：ER 阴性组、PR 阴性组、Ki －67高表达组的新辅助化疗有效率分别为50．0％、49．1％、51．4％,高于 ER 阳性组26．0％、PR 阳性组25．5％、Ki －67低表达组9．4％（P ＜0．05）。Logistic 多因素回归分析显示,ER、Ki －67的表达水平是评估化疗疗效的独立因素（P ＜0．05）。Luminal 型乳腺癌总生存期高于 non －Luminal 型（Long －rank 检验,P ＜0．05）。结论：ER、Ki －67、分子亚型可作为局部进展期乳腺癌新辅助化疗疗效判断的重要预测指标。     

三阴性乳腺癌新辅助化疗后Ki67表达变化与患者生存的关系

目的探讨三阴性乳腺癌新辅助化疗后Ki67表达变化与患者预后的关系。 方法回顾性分析浙江省肿瘤医院2010年1月至2015年12月收治的102例三阴性乳腺癌患者临床资料。采用免疫组织化学方法检测新辅助化疗前后Ki67的表达情况。根据Ki67表达的变化将患者分为3组：A组,Ki67由低表达(≤20%)转为高表达(>20%);B组,Ki67表达无变化;C组,Ki67由高表达转为低表达。然后,采用Kruskal-Wallis秩和检验分析新辅助化疗后Ki67变化模式与患者疗效的关联性,并用Kaplan-Meier生存曲线和COX风险比例回归模型进行生存分析。 结果102例患者中,A组有11例(10.8%),B组有49例(48.0%),C组有42例(41.2%)。Ki67表达变化与新辅助化疗疗效临床评估及病理学评估均存在显著性关联(χ²＝23.617、41.412, P均<0.001)。中位随访34个月,A、B、C组的DFS率分别为36.4%、60.4%和88.1%,C组患者DFS率明显高于A组和B组(χ²＝14.980, P<0.001; χ²＝9.878, P＝0.002)。3组之间OS率比较,差异无统计学意义(χ²＝5.683, P＝0.058)。COX风险比例回归模型显示,新辅助化疗后Ki67表达降低是DFS和OS的独立影响因素(HR＝0.401, 95%CI：0.243～0.659, P<0.001;HR＝0.387, 95%CI：0.170～0.881, P＝0.024)。 结论新辅助化疗后Ki67表达变化与临床疗效评估及病理学评估间存在相关性。Ki67的变化可用于预测三阴性乳腺癌患者的预后,这对于该类患者新辅助化疗后的后续治疗具有一定的指导意义。     

乳腺癌新辅助化疗对雌激素受体孕激素受体人表皮生长因子受体和Ki67抗原标记指数表达的影响及意义

目的探讨新辅助化疗对乳腺癌患者雌激素受体(ER)、孕激素受体(PR)、人表皮生长因子受体-2(HER-2)和Ki67抗原标记指数表达的影响及意义。方法选取89例单侧女性乳腺癌患者,行氟尿嘧啶、表阿霉素和环磷酰胺(FEC化疗方案)新辅助化疗,采用免疫组化S-P法对化疗前后ER、PR、HER-2和Ki67的表达进行测定。观察其变化及与疗效间的关系。结果 NAC后完全缓解11例(12.4%);部分缓解51例(57.3%);病情稳定23例(25.8%);病情发展4例(4.5%)。行新辅助化疗后,ER阴性组、PR阴性组、Ki67阴性组的临床有效率显著升高,与阳性组比较差异均有统计学意义(P<0.05)。行新辅助化疗前后ER与Ki67的表达差异有统计学意义(P<0.05)。结论新辅助化疗前后ER、PR、HER-2和Ki67表达的变化可作为制定乳腺癌患者后期治疗方案、评估预后的指标。     

新辅助化疗疗效与乳腺癌Ki67、P53表达的关系

目的探讨新辅助化疗对乳腺癌Ki67、P53表达的影响,以及新的病理评估分级与Ki67、P53的关系。方法 用免疫组织化学染色法分别检测40例Ⅱ～Ⅲ期乳腺癌患者新辅助化疗前后Ki67、P53和其他生物学指标的表达,采用WHO实体肿瘤疗效评价标准和本院病理科制定的病理学分级标准分别对新辅助化疗疗效进行临床综合评估及病理学评价;根据Ki67、P53阳性细胞的百分数分为低表达组和高表达组,分别探讨Ki67、P53不同表达水平与新辅助疗效之间的关系。计数资料采用χ2检验或Fisher精确概率法,等级资料采用非参数秩和检验,相关性分析采用spearman相关。结果 （1）Ki67、P53在乳腺癌组织中的阳性表达率分别为62.5%（25/40）、40.0%（16/40）,高表达率分别为27.5%（11/40）、15.0%（6/40）。Ki67表达与HER-2状态有关（P=0.004）,而与患者年龄、临床分期、ER状态等无关（P〉0.050）;P53表达与一般病理因素均无关（P〉0.050）。（2）Ki67高表达患者新辅助化疗疗效优于低表达的患者（P=0.049）。（3）与新辅助化疗前相比,新辅助化疗后Ki67的阳性表达率显著下降（P=0.027）,但P53的阳性表达率无明显变化（P〉0.050）。（4）经病理学分级评估,Ki67表达的变化程度与新辅助化疗反应有相关性（r=0.347,P=0.028）,但P53的变化程度与新辅助化疗反应无相关性（P〉0.050）。结论 Ki67可作为预测和评估乳腺癌新辅助化疗疗效的生物学指标。     

Ki67在乳腺癌中的表达水平及其对新辅助化疗患者预后的评估价值

目的研究Ki67表达水平对乳腺癌新辅助化疗后患者预后的评估价值。方法调取行乳腺癌新辅助化疗的120例患者的临床资料,并对其临床病理指标、Ki67的表达及预后进行回顾性分析。结果乳腺癌患者的病理有效率与月经状态、病理组织学类型、雌激素受体状态无关,与原发肿瘤大小、淋巴结转移情况有关(P<0.01)。新辅助化疗后患者的Ki67阳性表达率与化疗前相比显著降低(P<0.01);在病理有效率方面,化疗前Ki67高表达组经新辅助化疗后有效率明显高于Ki67低表达组,差异具有统计学意义(χ~2=19.00,P<0.01);Ki67表达化疗前后明显下降组的病理有效率明显高于轻度下降组病理有效率,差异具有统计学意义(χ~2=89.68,P<0.01)。结论 Ki67呈高表达状态时提示乳腺癌患者新辅助化疗效果良好,同时其表达变化也可对患者的病情进行有效的评估。     

诱导化疗对舌鳞癌肿瘤细胞增殖的影响

目的探讨诱导化疗对舌鳞癌患者原发灶肿瘤细胞增殖的影响。方法用免疫组化方法检测了DDP+5-Fu方案诱导化疗后舌鳞癌组织PCNA和Ki67的表达状况。结果舌鳞癌诱导化疗后PCNA和Ki67抗原表达分别是76.8%和58.5%;在Ki67,诱导化疗前组和诱导化疗2周内手术组间存在统计学差异(P<0.05),诱导化疗前组和诱导化疗2周后手术组间无统计学意义(P>0.05),2周内手术组和2周后手术组间存在统计学意义(P<0.05);三组间PCNA均无统计学差异。结论舌鳞癌诱导化疗后Ki67较PCNA更能较准确的反映肿瘤细胞的增殖状态;诱导化疗后舌鳞癌原发灶手术切除应于2周内完成。     

介入化疗对宫颈鳞状细胞癌细胞凋亡和增殖的影响

目的:探讨介入化疗对宫颈鳞癌的细胞凋亡和增殖的影响.方法:选取宫颈鳞癌患者30例,介入化疗前后子宫组织,采用DNA缺口原位末端标记法(TUNEL)检测细胞凋亡,用凋亡指数(AI)表示;免疫组化染色SP法检测Ki67指数表达增殖变化,用LI表示;计算凋亡/增殖比例(AI/LI),并取30例正常宫颈上皮组织作为对照.结果:1)介入化疗后AI明显高于介入化疗前(P＜0.05).2)介入化疗后LI明显低于介入化疗前(P＜0.05).3)介入化疗前AI/LI(0.1293±0.079)低于对照组(0.2033±0.055),介入化疗后AI/LI(0.995 6±0.976)高于对照组,介入化疗后AI/LI明显高于介入化疗前,均有统计学意义(P＜0.05).结论:介入化疗能诱导宫颈癌细胞的凋亡,抑制宫颈癌细胞的增殖;AI/LI能表示细胞凋亡和增殖之间平衡.     

不同化疗方案对MCF-7乳腺癌荷瘤裸鼠的抑瘤作用及对PCNA表达的影响

Objective: To investigate the antitumor activity of different combination regimens to human breast cancer xenograft (MCF-7) transplanted in nude mice and the effects on the expression of PCNA, and to evaluate the value of PCNA as predictive factor for the response of chemotherapy and individualized treatment. Methods: (1) 88 nude mice models of human breast cancer xenograft (MCF-7) were established, and then were randomly divided into control group and 10 chemotherapy groups (each group, n = 8). Among them, the mice of 5 chemotherapy groups were treated intraperitoneally/orally by 5 combination chemotherapy regimens (CMF, CAF, NP, TP, Xeloda) respectively at 1/3 LD10 dosage schedule (dose lethal to 10%of the mice), and that in another 5 chemotherapy groups were treated at 2/3 LD10 dosage schedule. Control animals were administered intraperitoneally with normal saline. (2) The body weight of nude mice and transplanted tumor growth were observed and recorded, then inhibition rate of tumor growth was calculated. (3) The pathological features of transplanted tumor were studied under microscope. The expression of proliferating cell nuclear antigen (PCNA) was comparatively studied in chemotherapy group and control group by SP immunohistochemical method and flow cytometry analysis. Results: (1) Body weight, tumor weight and inhibition rate of tumor growth of athymic mice bearing cancer: Body weights and tumor weights of nude mice in every 2/3 LD10 chemotherapy group were significantly lower than those of the control group (P ＜ 0.05), and the inhibition rates of tumor growth were 83.1%, 75.5%, 84.6%, 87.9% and 91.0%, respectively. Body weights of athymic mice in every 1/3 LD10 chemotherapy group were lower than that of the control (P ＜ 0.05). The results showed that the 2/3 LD10chemotherapy groups could reflect the effect of combination chemotherapy on the nude mice and the clinical dependability was better. So the data of 2/3 LD10 chemotherapy groups were appropriated for successive study. (2) Immunohistochemical studies: The expressions of PCNA in every chemotherapy group were significantly lower than that of the control (P ＜ 0.05).Moreover, the expression of PCNA in NP group was significantly lower than those of CMF, CAF, TP and Xeloda groups (P ＜0.05), while the expressions of TP and Xeloda groups were significantly lower than those of CMF and CAF groups (P ＜ 0.05).(3) FCM analysis: FI values of PCNA in every chemotherapy group were significantly lower than that of the control (P ＜ 0.05).FI values of PCNA in TP and Xeloda groups were significantly lower than those of CMF and CAF groups (P ＜ 0.05), while the value of NP group was significantly lower than that of CMF group (P ＜ 0.05). (4) Relationship between PCNA expression and pathologic response: The expression of PCNA was significantly correlated with pathological therapeutic response of transplanted breast carcinoma (P = 0.001). Conclusion: In vivo chemosensitivity testing with 2/3 LD10 dosage combinations in nude mice bearing cancer can reflect the effects of chemotherapeutics and affects of organism exactly. Various chemotherapy regimens all can decrease the expression of PCNA in breast cancer. The PCNA can be regarded as the factor to judge the response to chemotherapy, and it become possibly one of the prospective factors in the selection of chemotherapy regimen and play a rule in individualized therapy in the clinic.     

Correlation of Preoperative Ki67 and Serum CA15.3 Levels with Outcome in Early Breast Cancers a Multi Institutional Study

Background: To investigate the association between preoperative pathological Ki67 labeling index and serum tumor marker cancer antigen 153 (CA 153) with clinicpathological parameters and treatment outcomes in early breast cancer. Materials and Methods: A retrospective study at 4 cancer centers in Saudi Arabia and Egypt was performed. Data were collected for female patients diagnosed with unilateral early breast cancer between March 2010 and October 2013. Cases treated with neoadjuvant chemotherapy (NACT) followed by surgery and radiotherapy were included. NACT included 68 cycles of anthracycline and taxane based regimens. Trastuzumab and hormonal treatments were added according to HER2 and hormone receptor status. Baseline serum CA15.3 and pathological Ki67 levels were evaluated and correlated with disease free survival (DFS) and overall survival (OS). Results: A total of 280 pts was included. The median age was 49 years (3866 y) and median overall survival was 35 (2038) months (mo). Estrogen receptors (ER), progesterone receptors (PR) and HER 2 receptors were positive in 233 (83.2%), 198 (70%) and 65 cases (23.2%), respectively. High preoperative Ki67 and CA15.3 were noted in 177 (63.2%) and 131 (46.8%). A total of 45 (16%) patients had distal or local recurrence and 24 (8.6%) died of their disease. Most of the relapsed cases had high preoperative Ki67 (n41, 91%) and CA15.3 (n28, 62%) values. All of the patients who died had a high Ki67 but CA15.3 was high in 9 (37%) only. Mean DFS/OS in patients with high preoperative Ki67 was 32 months /32 months as compared to 37 months/35 months in those with normal Ki67 (p<0.001). Correlation of preoperative CA15.3 and survival was statistically not significant. Conclusions:Preoperative Ki67 can be a predictive and prognostic marker. Higher levels are associated with poor DFS and OS in patients with early BC.     

Letrozole plus GnRH analogue as preoperative and adjuvant therapy in premenopausal women with ER positive locally advanced breast cancer

Patients with large ER positive tumors candidate to preoperative chemotherapy may also benefit from a concurrent endocrine intervention, but this issue has been scarcely investigated due to concerns arising from unfavorable results emerged from an adjuvant trial of concurrent tamoxifen and chemotherapy. We retrospectively investigated the activity of letrozole plus GnRH analogue (GnRH-a) administered concurrently with preoperative chemotherapy and as adjuvant treatment in premenopausal women with locally advanced ER positive breast cancer consecutively admitted at the European Institute of Oncology. Results were compared with those of a non-randomized unmatched control group of premenopausal women with locally advanced ER positive breast cancer receiving preoperative chemotherapy, followed by tamoxifen and GnRH-a after surgery. Primary endpoints were pathological complete response (pCR) rate, decrease of Ki67 and disease free survival (DFS). One-hundred and nineteen women constituted the study group, while 95 patients served as controls. The pCR rate was 5.0 vs 1.1% in the study and control group, respectively. A statistically significant greater suppression of Ki67 was observed in patients receiving chemoendocrine therapy as compared with controls (P = 0.003). At a median follow up of 59 months, 26 events occurred in the chemoendocrine group and 48 in the control group. Five-year DFS was 78 vs 41% in the study and in the control group, respectively [adjusted HR 0.46, 95% CI 0.27-0.79, P = 0.0047]. The concurrent administration of letrozole and GnRH-a with preoperative chemotherapy was highly effective in premenopausal women with large ER positive breast cancer in terms of decreased proliferation and of improved DFS. Randomized studies are warranted to establish the role of the addition of endocrine therapy to chemotherapy as standard preoperative approach for ER positive locally advanced breast cancer as well as of letrozole in combination with GnRH-a for the treatment of premenopauasal women with early breast cancer.     

Impact of neoadjuvant chemotherapy on Ki-67 and PCNA labeling indices for esophageal squamous cell carcinomas

PURPOSE: The effects of neoadjuvant chemotherapy (CT) on Ki-67 and proliferating cell nuclear antigen (PCNA) labeling index (LI) were analyzed, using biopsy and surgical specimens of esophageal cancer. METHOD AND MATERIALS: Immunohistochemical staining for Ki-67 and PCNA was performed for biopsy and surgical specimens of 35 patients with esophageal squamous cell carcinoma. Seventeen patients were treated with neoadjuvant CT (CT group), while no preoperative treatment was performed for the remaining 18 patients (control group). As neoadjuvant CT, cisplatin of 50 mg/body/week was administered 2-5 times (100-250 mg in total) until 7-10 days before subtotal esophagectomy. RESULT: Significant correlation between the LIs of biopsy and surgical specimens was observed for the control group (p = 0.006 for Ki-67 and p = 0.005 for PCNA), although both LIs of surgical specimens were significantly higher than those of biopsy specimens (p < 0.05). However, no significant correlation between LIs of biopsy specimens and those of surgical specimens was observed for the CT group. In addition, the LIs of the surgical specimens of the CT group were significantly lower than the LIs of the control group (p < 0.005 for Ki-67 and p < 0.05 for PCNA). Significant decrease in Ki-67 LI after neoadjuvant CT was noted especially for well or moderately differentiated squamous cell carcinomas and/or tumors treated with high-dose cisplatin (150-250 mg). CONCLUSION: Significant correlation of Ki-67 and PCNA LIs between biopsy and surgical specimens was demonstrated for the control group. Neoadjuvant CT decreased the percentage of cycling and proliferative tumor cells of esophageal cancer.     

Early changes in apoptosis and proliferation following primary chemotherapy for breast cancer

Patients undergoing primary chemotherapy for invasive breast cancer consented to a core biopsy of the invasive breast primary pre- and 24 h postchemotherapy. The resulting tissue was analysed for apoptosis, Ki67, ER and HER-2 using immunohistochemical techniques. These data were then used to evaluate the relationship between these biological markers and response to chemotherapy and overall survival. Response rate to chemotherapy in this group was 86%, 16 patients (25%) achieved a clinical complete response and 41 (63%) a partial response. Prechemotherapy there was a significant correlation between Ki67 and apoptotic index (AI), r=0.6, (P<0.001). A significant rise in AI (P<0.001), and fall in Ki67 (P=0.002) was seen 24 h following chemotherapy. No relationship was seen between pretreatment AI and clinical response, but higher Ki67 and growth index (Ki67/AI ratio, GI) did correlate with clinical response (both r=0.31, P<0.025). No correlation was seen between the change in AI or Ki67 at 24 h and clinical response or survival. Significant changes in apoptosis and proliferation can be demonstrated 24 h following chemotherapy, but these changes do not relate to clinical response or outcome in this study. Pretreatment proliferation and GI are however predictive of response to chemotherapy in breast cancer.     

细胞块免疫细胞化学在乳腺癌术前辅助化疗中的意义

目的:探讨细胞块免疫细胞化学在乳腺癌术前辅助化疗中的临床价值。方法:用10ml持笔式负压穿刺器穿刺乳腺癌患者肿物,血浆凝血酶方法制做成细胞块,选择术前已做细胞块,并且术后有病理组织学对照的乳腺癌90例分别进行免疫组化标记。抗体选用ER、PR、cerbB-2、P53、VEGF、Ki67。结果:细胞块免疫细胞化学结果:阳性率分别为ER 68%、PR 63%、cerbB-2 30%、P53 34%、VEGF 57%、ki67 79%。术后病理组织免疫组化结果:ER 70%、PR 66%、cerb-2 32%、P53 37%、VEGF59%、Ki67 81%。结论:持笔式负压穿刺器穿刺乳腺癌组织,血浆凝血酶法制做的细胞块,不仅操作简便快捷、安全、不需特殊设备,而且可连续切片做多种抗体检测以满足诊断需要,其免疫细胞化学结果和术后病理免疫组织化学结果对比无明显差异。乳腺癌辅助化疗前用细胞块制备的标本检测ER、PR、cerbB-2、P53、VEGF、Ki-67,能了解乳腺癌患者内分泌情况及恶性程度和预后,为术前辅助化疗及内分泌治疗提供必要的参考指标,从而对乳腺癌患者进行针对性的个体化疗方案,增加乳腺癌患者保乳手术机会,提高患者的生存期和治愈率。