Ki-67 as a Predictor of Response to Neoadjuvant Chemotherapy in Breast Cancer Patients

Purpose

The objectives of this study were to assess the potential value of Ki-67 in predicting response to neoadjuvant chemotherapy in breast cancer patients and to suggest a reasonable cutoff value for classifying Ki-67 expression.

Methods

This study included 74 breast cancer patients who underwent surgery after anthracycline-based neoadjuvant chemotherapy between 2007 and 2012. We analyzed the clinical and immunohistochemical characteristics using core biopsy specimens obtained before neoadjuvant chemotherapy to determine their correlations with the response to chemotherapy.

Results

A clinical complete response was observed in 6 patients (8.1%); a clinical partial response, in 44 patients (59.5%); and clinical stable disease, in 24 patients (32.4%). A pathologic complete response (pCR) was observed in 10 patients (13.5%). In univariate analysis, estrogen receptor (ER) negativity (p=0.031), human epidermal growth factor receptor 2 (HER2) positivity (p=0.040), and high Ki-67 expression (p=0.036) were predictive factors for a pCR. In multivariate analysis, Ki-67 was the only independent predictor of a pCR (p=0.049). The analysis of Ki-67 values revealed that 25% was a reasonable cutoff value for predicting the response to chemotherapy. In subgroup analysis, a higher Ki-67 value (≥25%) was a significant predictive factor for the response to neoadjuvant chemotherapy, especially in ER-negative and HER2-positive breast cancer patients.

Conclusion

Ki-67 expression in breast cancer tissue may be an effective factor for predicting the response to neoadjuvant chemotherapy. We suggest that a 25% level of Ki-67 expression is a reasonable cutoff value for predicting a response to chemotherapy. Moreover, Ki-67 is a useful predictive factor for pCR, especially in patients with ER-negative and HER2-positive breast cancer.     

Identification of Luminal Subtypes of Breast Carcinoma Using Surrogate Immunohistochemical Markers and Ascertaining Their Prognostic Relevance

BackgroundTherapeutic decisions in breast carcinoma are being made on the basis of tumor cell proliferation using exorbitant genomic tests. The 2013 St Gallen meeting advocated surrogate definitions for classifying tumors into luminal subtypes on the basis of immunohistochemical (IHC) markers. We studied the classification of estrogen receptor (ER)-positive tumors using these definitions as well as different methods for Ki-67 labeling index (LI) estimation.Patients and MethodsA total of 541 ER⁺ invasive breast carcinoma cases from January 2012 to December 2012 were evaluated for Ki-67 LI by the average and hot spot methods. The IHC results of ER, PR, and human epidermal growth factor receptor 2 (HER2) were noted. HER2 IHC equivocal (2+) samples were subjected to HER2 fluorescence in-situ hybridization testing. Luminal subgroups created on the basis of the 2013 St Gallen meeting guidelines were correlated with clinicopathologic variables and disease-free survival.ResultsThe distribution of luminal subtypes was as follows: luminal A–like, 13.3%; luminal B–like (HER2⁻), 57.9%; and luminal B–like (HER2⁺), 28.8%. Approximately 6% of cases were recategorized into different subgroups when the average method was used instead of the hot spot method for Ki-67 LI assessment. Younger patients (≤ 50 years), grade 3 tumors, positive axillary nodes, recurrence, and distant metastasis had a positive statistical correlation with luminal B–like (HER2⁻) subtype. Patients with luminal B–like (HER2⁻) tumors had a shorter disease-free survival compared to patients with luminal A–like tumors.ConclusionKi-67 LI, irrespective of the method of assessment, along with PR, can be efficiently used to divide ER⁺ tumors into prognostic subgroups in Indian patients.     

Differences in Clinical Outcomes between Luminal A and B Type Breast Cancers according to the St. Gallen Consensus 2013

Purpose

Human epidermal growth factor receptor 2 (HER2)-positive luminal B type comprises estrogen receptor (ER)-positive and HER2-positive cancers, and HER2-negative luminal B type comprises ER-positive cancers showing a Ki-67 labeling index ≥14% or progesterone receptor (PR) expression of <20% according to the St. Gallen consensus 2013. The current study aimed to classify intrinsic subtypes according to the St. Gallen consensus 2013 and determine the differences in clinicopathological parameters and survival outcomes among the molecular types, especially among the luminal types.

Methods

Assessment of molecular types was performed for 267 invasive ductal carcinomas. The differences in clinicopathological parameters, disease-free survival (DFS), and overall survival (OS) among the molecular types were analyzed.

Results

The luminal B type was the most prevalent, at 44.9%, followed by the luminal A, triple-negative (including basal-like type), and HER2 type, at 21.7%, 18.7%, and 14.6%, respectively. There were statistically significant differences in size (p=0.003), nodal status (p=0.046), histologic grade (p<0.001), p53 (p<0.001) and cyclooxygenase 2 (COX-2) positivity (p=0.002), recurrence (p=0.001) and death rates (p=0.036), DFS (p=0.002), and OS (p=0.039) among the molecular types. Significant differences in size (p=0.009), nodal metastasis (p=0.019), histologic grade (p<0.001), p53 positivity (p=0.001), and PR expression (p<0.001) were noted between the luminal A and B types. Among the luminal B type cancers, the distributions of ER and PR scores showed significant differences (p=0.003, p=0.003). p53 positivity in the luminal B type cancers was related to shortened DFS (p=0.034). In luminal type cancers, COX-2 positivity was related to longer DFS (p=0.026).

Conclusion

Different management guidelines should be considered for the luminal A and luminal B breast cancer types. Positive p53 expression in luminal B type cancers and negative COX-2 expression in luminal type cancers seem to be related to poor clinical outcome.     

雌激素相关标志在乳腺癌中的表达及其预后意义

用一组雌激素相关标志对54例女性乳腺癌进行回顾性研究。患者平均47．9岁，5年生存率为81.5％。癌肿长径平均3．4cm，浸润性导管癌49例，Ⅲ级36例。肿瘤大小、组织学类型、分级与预后关系不明显。ER阳性率55．6％，PR阳性率389％，与组织蛋白酶D有较好相关性。组织蛋白酶D在癌细胞的阳性年为278％，间质巨噬细胞阳性率为100％，与ER、PR关系较密切，并与预后相关。     

MCM5及Ki-67蛋白表达与乳腺癌新辅助化疗近期疗效关系的研究

目的:探讨人乳腺癌新辅助化疗前后MCM5和Ki-67蛋白的表达状况,分析其与化疗疗效关系的意义.方法:采用免疫组化法检测40例乳腺癌新辅助化疗前后标本中MCM5和Ki-67的表达.结果:新辅助化疗有效率为77.5%.化疗前MCM5和Ki-67蛋白阳性表达显著高于化疗后(P＜0.01);化疗前MCM5蛋白阳性表达显著高于Ki-67(P＜0.01).化疗有效组(31例)MCM5蛋白阳性表达显著高于无效组(9例)(P＜0.01);化疗有效组Ki-67蛋白阳性表达高于无效组,但差异无显著性(P＞0.05).化疗前MCM5、Ki-67表达呈正相关(r=0.601,P＜0.01).结论:ET方案新辅助化疗有较好的疗效,可能通过抑制MCM5、Ki-67蛋白的表达来阻止乳腺癌细胞的增殖.MCM5蛋白高表达者化疗更为敏感,MCM5可作为临床指导乳腺癌化疗并预测化疗敏感性的分子生物学指标之一.     

乳腺浸润性导管癌和浸润性小叶癌细胞粘附分子与雌、孕激素受体表达及意义

目的：探讨乳腺浸润性导管癌（invasive ductal carcinoma,IDC)和浸润性小叶癌（invasive lobular carcinomaILC)组织中细胞粘附分子和雌、孕激素受体（estrogen receptor,ER:progesterone receptor,PR)表达的意义。E -α-catenin,--catenin,γ-catenin和ER、PR的表达。结果：E-cadherin在IDC和ILC中表达缺失和明显减少的分别占18.7%和30%,α-catenin,β-catenin,γ-catenin在IDC中表达缺失和明显减少的分别为75%,43.8%和明显的正相关性;γ-catenin在乳腺浸润性癌中的表达缺失和明显减少与淋巴结转移病例之间有显著的关系。ER和PR在IDC中表达有明显的正相关性。结论：除E-cadherin外,α-catenin,β-catenin,γ-catenin在乳腺浸润性导管癌和浸润性小叶癌中表达明显缺失和减少。γ-catenin表达缺失和明显减少可作为乳腺浸润性癌伴有淋巴结转移的一个预后指标。ER、PR与E-cadherin,α-catenin,β-catenin,γ-catenin可能是乳腺浸润性癌两类独立的预后指标。     

Concurrent Gonadotropin-Releasing Hormone Agonist Administration with Chemotherapy Improves Neoadjuvant Chemotherapy Responses in Young Premenopausal Breast Cancer Patients

Purpose

This study aimed to determine the oncologic efficacy of gonadotropin-releasing hormone (GnRH) agonist treatment concurrent with chemotherapy in a neoadjuvant setting.

Methods

A retrospective analysis was performed on 332 cases of invasive breast cancer in patients who were <40 years old at diagnosis and received GnRH agonists concurrent with neoadjuvant chemotherapy (GnRH agonist group) or neoadjuvant chemotherapy alone (neochemotherapy-alone group) from December 2010 to September 2014. Pathologic complete response rates (pCR) and Ki-67 changes were evaluated between the two groups.

Results

Median age was 32±3.9 and 36±3.0 years in the GnRH agonist group and neochemotherapy-alone group, respectively (p<0.001). After adjustment for tumor size, grade, lymph node metastasis, hormone receptor (HR) status, and chemotherapy regimen, the GnRH agonist group exhibited a higher pCR rate with an odds ratio (OR) of 2.98 (95% confidence interval [CI], 1.37-6.34) and a greater decrease in Ki-67 expression after treatment (p=0.05) than the neochemotherapy-alone group. For HR-negative tumors, the GnRH agonist group showed a higher pCR rate (multivariate OR, 3.50; 95% CI, 1.37-8.95) and a greater decrease in Ki-67 expression (p=0.047). For HR-positive breast cancer, the pCR rate, change in Ki-67 index, and clinical response were higher, and preoperative endocrine prognostic index scores were lower, in the GnRH agonist group, but these did not reach statistical significance.

Conclusion

Concurrent administration of GnRH agonists during neoadjuvant chemotherapy improved pCR rates and suppressed Ki-67 expression, especially in HR-negative tumors.     

Response of Triple Negative Breast Cancer to Neoadjuvant Chemotherapy: Correlation between Ki-67 Expression and Pathological Response

Triple-negative breast cancers constitute about 15% of all cases, but despite their higher response to neoadjuvant chemotherapy, the tumors are very aggressive and associated with a poor prognosis as well as a higher risk of early recurrence. This study was retrospectively performed on 101 patients with stage II and III invasive breast cancer who received 6–8 cycles of neo-adjuvant chemotherapy. Out of the total, 23 were in the triple negative breast cancer subgroup. Nuclear Ki-67 expression in both the large cohort group (n=101) and triple negative breast cancer subgroup (n=23) and its relation to the pathological response were evaluated. The purpose of the study was to identify the predictive value of nuclear protein Ki-67 expression among patients with invasive breast cancers, involving the triple negative breast cancer subgroup, treated with neoadjuvant chemotherapy in correlation to the rate of pathological complete response. The proliferation marker Ki-67 expression was highest in the triple negative breast cancer subgroup. No appreciable difference in the rate of Ki-67 expression in triple negative breast cancer subgroup using either a cutoff of 14% or 35%. Triple negative breast cancer subgroup showed lower rates of pathological complete response. Achievement of pathological complete response was significantly correlated with smaller tumor size and higher Ki-67 expression. The majority of triple negative breast cancer cases achieved pathological partial response. The study concluded that Ki-67 is a useful tool to predict chemosensitivity in the setting of neoadjuvant chemotherapy for invasive breast cancer but not for the triple negative breast cancer subgroup.     

Ki-67抗原在膀胱癌中的表达及其意义

目的探讨Ki-67抗原在膀胱癌中的表达及其与膀胱癌分级、分期的关系。方法采用免疫组织化学法检测Ki-67抗原在60例膀胱癌患者和20例膀胱良性病变和10例正常膀胱黏膜中的表达。结果Ki-67抗原在60例膀胱癌标记指数为25．9％,在20例膀胱良性病变为103％,在10例正常膀胱黏膜中为1．1％,各组间差异有统计学意义;Ki-67抗原随着膀胱癌病理分级和临床分期的增加而表达升高。结论Ki-67抗原在膀胱癌细胞中表达升高并与膀胱癌分期、分级密切有关,Ki-67的表达可以作为评价细胞增生状态的指标,有可能成为判断肿瘤发生、发展、预后的重要指标。     

E-钙黏蛋白及Ki67在三阴性乳腺癌中的表达及临床意义

目的探讨E-钙黏蛋白、Ki67在三阴性乳腺癌(TNBC)中的表达及临床意义。 方法回顾性分析陆军军医大学新桥医院2010年1月至2013年12月收治的77例女性TNBC患者临床资料。采用免疫组织化学方法检测E-钙黏蛋白和Ki67的表达情况,通过χ²检验分析其与患者临床病理资料的关系。由于77例患者中有5例失访,本研究仅对随访资料完整的72例患者采用Kaplan-Meier法、Log-rank检验、Cox逐步回归模型进行生存分析和危险因素分析。 结果在77例患者中,E-钙黏蛋白的表达与淋巴结状态有关(χ²＝16.428,P<0.001),而Ki67表达与组织学分级有关(χ²＝7.218,P＝0.007)。中位随访59个月,72例患者的DFS率和OS率分别为58.3%、68.1%。其中,E-钙黏蛋白高表达者DFS率和OS率均高于低表达者(DFS率：75.9%比46.5%,χ²＝7.553,P＝0.006;OS率：82.8%比58.1%,χ²＝5.132,P＝0.023),而Ki67低表达者DFS率和OS率均高于高表达者(DFS率：84.0%比44.7%,χ²＝9.486,P＝0.002;OS率：92.0%比55.3%,χ²＝9.006,P＝0.003)。Cox逐步回归模型分析显示,淋巴结转移、组织学分级高是患者DFS的独立危险因素(OR＝4.030, 95%CI：1.854～8.757, P<0.001; OR＝2.879,95%CI：1.359～6.100,P＝0.006),Ki67高表达、淋巴结转移是OS的独立危险因素(OR＝5.067,95%CI：1.179～21.768, P＝0.029; OR＝6.253,95%CI：2.296～17.034, P<0.001)。 结论E-钙黏蛋白高表达和Ki67低表达的TNBC预后良好,这对于乳腺癌的个体化治疗具有一定的指导意义。     

Prognostic Value of the Nodal Ratio and Ki-67 Expression in Breast Cancer Patients Treated with Postmastectomy Radiotherapy

Purpose

This pilot study aimed to evaluate prognostic factors of postmastectomy radiotherapy (PMRT) for breast cancer patients undergoing systemic therapy in either preoperative or postoperative setting.

Methods

Between 2003 and 2009, 113 patients received PMRT: 61 underwent preoperative systemic therapy (PST subgroup) and 52 received postoperative systemic therapy (non-PST subgroup).

Results

The median follow-up time was 72.3 months (range, 34.0-109.4 months) for surviving patients. In univariate analysis of all patients, disease-free survival (DFS) was associated with age, nodal ratio (NR), and Ki-67 expression; overall survival (OS) was associated with NR and Ki-67 expression. Pathologic N stage and HER2 expression were marginally associated with DFS and OS. In the non-PST subgroup, DFS was associated with age, NR, venous invasion, and Ki-67 expression; OS was associated with age. In the PST subgroup, DFS was associated with ypN stage and NR; OS was associated with ypN, histologic grade, HER2 expression, and p53 expression. In multivariate analysis of all patients, DFS and OS were significantly associated with NR (p=0.003 and p=0.019, respectively) and Ki-67 expression (p=0.002 and p=0.015, respectively). Patients were classified into low-risk (NR ≤0.2 and Ki-67 ≤20%; n=34), intermediate-risk (NR >0.2 or Ki-67 >20%; n=63), and high-risk (NR >0.2 and Ki-67 >20%; n=16) subgroups. All low-risk patients were alive at the time of analysis. High-risk (p<0.001 and p=0.001, respectively) and intermediate-risk (p=0.022 and p=0.008, respectively) patients had significantly shorter DFS and OS than low-risk patients. This prognostic model was statistically significant for DFS when applied to the PST (p=0.001) and non-PST (p=0.016) subgroups separately.

Conclusion

For breast cancer patients undergoing PMRT, NR and Ki-67 are potential prognostic factors. A model using these factors might help predict a poor prognosis. Whether NR and Ki-67 are also prognostic for different setting of systemic therapy, preoperative or postoperative, warrants further study.     

Ki-67对早期乳腺癌治疗和预后的指导意义

Ki-67是一种在增殖细胞中表达的核抗原,与临床分期、淋巴结状态和人表皮生长因子受体-2(Her-2)呈正相关,而与雌激素受体(ER)呈负相关.Ki-67高表达是细胞具有极度增殖活性的表现,内分泌治疗和化疗均对其表达有影响.Ki-67是早期乳腺癌的独立预后因素,亦可联合其他基因共同指导乳腺癌的预后,并可对乳腺癌的预后分级提供辅助信息.     

Reliability of Sentinel Lymph Node Biopsy after Neoadjuvant Chemotherapy in Breast Cancer Patients

Purpose

Sentinel lymph node biopsy (SLNB) is an accurate and effective means of axillary nodal staging in early breast cancer. However its indication after neoadjuvant chemotherapy (NAC) is under constant debate. The present study evaluates the reliability of SLNB in assessing axillary nodal status after NAC.

Methods

Data from 281 patients who had received NAC and subsequent SLNB were reviewed. The identification and false negative rates of SLNB were determined and the clinicopathologic factors associated with false negative results were investigated using univariate analysis.

Results

The identification rate of SLNB after NAC was 93.6% and the false negative rate was 10.4%. Hormone receptor status, especially progesterone receptor positivity, was significantly associated with false negative results. The accuracy of intraoperative frozen section examination of sentinel lymph nodes was 91.2%.

Conclusion

The identification rate of SLNB and the accuracy of intraoperative frozen section examination after NAC are comparable to the results without NAC in patients with early breast cancer. However considering the high false negative rates, general application of SLNB after NAC should be avoided. Patients with progesterone-positive tumors and non-triple-negative breast cancers may be a select group of patients in whom SLNB can be employed safely after NAC, but further studies are necessary.     

Comparative Study of the Immunohistochemical Phenotype in Breast Cancer and Its Lymph Node Metastatic Location

At present, an important part of prognostic information, together with particular treatment strategies in breast cancer, take into account the immunohistochemical phenotype of the primary tumor location. However, the changing heterogeneity intrinsic to neoplastic cells in general leads us to consider the possibility that the expression of these proteins is modified during tumoral development and dissemination. With this hypothesis as a starting point, 60 patients with breast cancer were studied with immunohistochemistry, the expression of estrogen and progestagenic receptors, proliferation through the Ki-67 expression, and the overexpression of HER-2 and p53 in both the primary location and the lymph node metastases. If we consider significant change to be loss (from positive to negative) or gain (negative to positive) of expression in some of the studied determinations, we find that this is produced in 60% of the tumors studied. These results demonstrate the modification of immunohistochemical expression of the proteins studied between the primary tumor location and the lymph node metastases.     

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。     

宫颈鳞癌新辅助化疗敏感性预测指标的研究

[目的]观察CD44v6、PCNA、Ki-67作为宫颈鳞癌新辅助化疗治疗敏感性预测指标的可行性.[方法]24例宫颈鳞癌患者采用顺铂、羟基喜树碱、博来霉素方案进行术前2个疗程的新辅助化疗,对化疔前的宫颈鳞癌组织以流式细胞术检测组织中CD44v6及PCNA、Ki-67的表达,研究三者与化疗疗效之间的关系.[结果]化疗前宫颈鳞癌组织中CD44v6及PCNA、Ki-67平均检测值分别为0.481±0.150、0.386±0.078、0.550±0.127:临床观察化疗有效率为83.3%,化疗后肿瘤病灶缩小程度平均为0.633±0.214.化疗后肿瘤病灶缩小与CD44v6之间呈显著负相关(r=-0.853,P＜0.001),与PCNA、Ki-67检测值无显著相关性(r=0.057,P=0.791;r=0.022,P=0.919).[结论]CD44v6可以作为宫颈鳞癌新辅助化疗治疗敏感性预测指标.     

Predictors of Pathological Complete Response to Neoadjuvant Chemotherapy in Iranian Breast Cancer Patients

Background: Achievement of pathologic complete response (pCR) in breast cancer patients receiving neoadjuvant chemotherapy (NAC) is associated with both overall survival and disease-free survival. The aim of present study was to identify clinical and pathological factors associated with achieving pCR in Iranian breast cancer patients receiving NAC. Methods: A retrospective review of all breast cancer patients treated with neoadjuvant chemotherapy between April 2012 and September 2016 at our institution was performed; 207 cases were evaluable for analysis. pCR was defined as having no residual invasive tumor in the breast surgical specimen removed following neoadjuvant therapy. Results: In univariate analysis, factors associated with pCR were age less than 35 years (p = 0.03), absence of Lymphovascular invasion (LVI) (p = 0.002) and negative hormone receptor status (p = 0.003). Hormone receptor status (P = 0.01; OR, 2.45; CI, 1.20 - 4.99) and LVI (P = 0.001; OR, 0.22; CI, 0.10 - 0.46) remained predictive variables in multivariate analysis after correction for the other variables. Conclusions: In conclusion, the results of this study suggests that presence of Lymphovascular invasion and positive hormone receptor status are associated with poorer response to neoadjuvant chemotherapy in breast cancer patients.     

肿瘤浸润性淋巴细胞比例在乳腺癌新辅助化疗中的意义

目的 探讨肿瘤浸润性淋巴细胞比例与乳腺癌新辅助化疗疗效的关系。方法 收集南京医科大学第一附属医院2010年12月—2013年11月期间接受新辅助化疗后可确认手术切除的59例女性乳腺癌患者资料,采用肿瘤浸润淋巴细胞计数评分检测化疗前每个患者的肿瘤内与间质内淋巴细胞计数总得分及术后间质内淋巴细胞计数得分,并采用Miller和Payne（MP）治疗反应评价方法评价术后乳腺癌组织的病理治疗反应,统计分析两者间的关系。结果 浸润淋巴细胞高比例组（3~6级）的新辅助化疗有效率明显高于低比例组（0~2级）,差异具有统计学意义（P＝0.001),化疗后间质淋巴细胞比例提高组化疗有效率高于比例无变化组,差异具有统计学意义（P＝0.031)。结论 肿瘤浸润淋巴细胞和化疗反应之间存在较强的相关性,肿瘤浸润性淋巴细胞可望成为预测新辅助化疗疗效的一个重要参数。     

顺铂联合长春地辛治疗晚期乳腺癌22例

（目的）观察低剂量DDP＋VDS为主的联合化疗对晚期乳腺癌的治疗效果。（方法）22例晚期乳腺癌，采用CMVP方案9例，CFW方案5例，CAVP方案8例，一个疗程后评价疗效及毒性反应。（结果）总有效率68．2％。其中CMVP667％，CFVP60．0％，CAVP75．0％。初治有效率66．7％，复治有效率57．9％，两者相比差异无显著性（P＞0．05）。主要毒副反应为胃肠反应、骨髓抑制、脱发、静脉炎；末梢神经炎及肾毒性轻。（结论）以低剂量DDP＋VDS为主的联合化疗方案治疗晚期乳腺癌毒副反应轻、患者易接受、疗效高于以DDP为主或VDS为主的联合化疗，两者联合可作为治疗晚期乳腺癌的一线方案。     

用多分子标记物预测新辅助化疗疗效

目的探讨ER、PR、C-erbB-2和P53与乳腺癌新辅助化疗疗效的相关性。方法局部晚期乳腺癌患者接受EC或TP方案化疗,化疗前空芯针穿刺活检,采用免疫组化法检测肿瘤组织的ER、PR、C-erbB-2和P53的表达情况。结果22例新辅助化疗RR达81．8％,其中CR5例（22．7％）,pCR4例（18．2％）,PR13例（59．1%）,SD4例（18．2％）。研究发现ER、PR和C-erbB-2表达在3组间有显著性差异,但与新辅助化疗的疗效无关联性。结论ER、PR和C-erbB-2的表达在不同疗效组有差异,但目前不能预测新辅助化疗的疗效。