乳腺癌组织Ki67表达与蒽环类联合紫杉类新辅助化疗效果的相关性

目的 探讨乳腺癌原发病灶肿瘤组织Ki67表达与葸环类联合紫杉类新辅助化疗疗效之间的相关性.方法 2008年1月至2009年6月共129例乳腺癌患者接受蒽环类联合紫杉类新辅助化疗,采用免疫组化方法前瞻性检测乳腺原发病灶粗针病理切片Ki67的表达水平,采用实体肿瘤疗效评价标准(RECIST 2000)及Miller-Payne病理学分级标准分别对新辅助化疗疗效进行MRI及病理学评价,并在此基础上进行临床疗效综合评价;探讨Ki67不同表达水平与疗效之间的相关性.结果 129例患者行新辅助化疗后经MRI评价87例(67.4%)有效,经组织病理学评价99例(76.7%)有效,经临床疗效综合评价110例有效(85.5%).Ki67表达≤10%组上述三种疗效评价方法的有效率分别为50.0%、62.5%及71.9%;Ki67表达>10%组则分别为73.2%、81.4%及89.7%;两组比较差异均有统计学意义(P值分别为0.020、0.030、0.010).经统计检验,Ki67的表达水平与临床综合疗效呈线性相关.结论 Ki67高表达的乳腺癌患者行蒽环类联合紫杉类新辅助化疗效果更好.

Relationship between Ki67 expression and tumor response to neoadjuvant chemotherapy with anthracyclines plus taxanes in breast cancer

Objective To investigate the relationship between Ki67 expression and tumor response to neoadjuvant chemotherapy with anthracyclines plus taxanes in breast cancer. Methods From January 2008 to June 2009, 129 patients with primary breast invasive ductal cancer received neoadjuvant chemotherapy with anthracyclines plus taxanes. The expression of Ki67 in the tumor tissues was determined by using immunohistochemistry with core needle biopsy specimens prior to the chemotherapy. The tumor response to the chemotherapy was evaluated by dynamic enhanced MRI based on RECIST2000 criteria, pathologic response was assessed according to Miller-Payne grading system, and the clinical comprehensive response was evaluated based on MRI combined with pathologic response. Results Dynamic enhanced MRI classified 87 cases(67.4% ) as effective. According to the Miller-Payne grading system, 99 cases (76. 7% ) were ranged effective. One hundred and ten cases (85.5%) were recognized as clinically comprehensive effective. The effective rates of neoadjuvant chemotherapy in patients with a Ki67 expression > 10% evaluated by the above-mentioned three standards were 73.2% , 81.4% and 89.7% , respectively; and those in patients with a Ki67 expression ≤ 10% were 50. 0% , 62. 5% and 71. 9% , respectively. Compared with patients with a Ki67 expression ≤ 10% , the patients with a Ki67 expression > 10% had better response rates determined by all the three standards (P values were 0. 020, 0. 030 and 0. 010, respectively). The Ki67 expression in the tumor tissue was linearly correlated with clinically comprehensive response on the Linear-Linear association analysis. Conclusions There is a statistic association between Ki67 expression and tumor response to the neoadjuvant chemotherapy with anthracyclines plus taxanes in breast cancer, and the patients with a higher expression of Ki67 has a better tumor response to the chemotherapy.