ER、PR、HER2和Ki-67在乳腺癌新辅助化疗前后表达变化的临床意义

【摘要】 目的 探讨新辅助化疗前后ER、PR、HER2、Ki-67表达的改变与乳腺癌新辅助化疗疗效的关系。方法 收集广东省妇幼保健院乳腺外科2007年1月1日至2012年12月31日收治的72例接受新辅助化疗的ⅡA~ⅢC期的乳腺癌资料,回顾性分析临床特征、ER、PR、HER2及Ki-67表达水平与新辅助化疗疗效的关系。结果 72例乳腺癌患者新辅助化疗总有效率(RR)为76.4%(55/72),其中有16.7%(12/72) 病例达临床完全缓解(CR),59.7%(43/72)病例达临床部分缓解(PR)。23.6%(17/72)的病例为病情稳定(SD),无患者获得疾病进展(PD),病理完全缓解(pCR)7例(9.72%)。原发肿瘤大小、ER、PR、Ki-67表达与新辅助化疗的临床有效率相关(P<0.05);病理完全缓解率(pCR)与ER、PR状态相关(P<0.05);ER新辅助前后发生改变的约22.2%,PR发生改变的约25.0%,HER2发生改变的约15.3%,Ki-67发生改变的约55.6%;新辅助化疗疗效与ER、PR、Ki-67化疗前后的改变相关(P<0.05),与HER2的改变无关(P>0.05)。结论 乳腺癌新辅助化疗后ER、PR、HER2和Ki-67的表达可发生改变,并且ER、PR和Ki-67表达的改变可预测新辅助化疗的疗效。

Clinical value of the changes of ER,.PR,.HER2 and Ki-67 expressions before and after neoadjuvant chemotherapy in breast cancer

Objective To investigate clinical value of the changes of ER,PR,HER2 and Ki67 expressions before and after neoadjuvant chemotherapy in breast cancer.Methods From January 2007 to December 2012,.the clinical data of 72 patients with locally advanced breast cancer,.which received neoadjuvant chemotherapy were collected..The relationship between curative effect of neoadjuvant chemotherapy and clinical feature,.ER,.PR,.HER2 and Ki-67 were analyzed retrospectively.Results In the 72 cases of breast cancer,the total effective rate of neoadjuvant chemotherapy was 76.4（55 /72）.Among them,CR,PR an SD were 16.7%（12 /72）,59.7%（43 /72） and 23.6%（17 /72） respectively.No progressed case was found.Pathological complete remission（pCR） was in 9.72%（7 /72）.There were significant relationships between the clinical effective rate of neoadjuvant chemotherapy and the size of primary tumor,ER,PR,HER 2 and Ki-67（P 0.05）.Pathological complete remission was correlated with the status of ER,and PR（P0.05）.The changes of ER,PR,HER2 and Ki-67 were in 22.2%,.25.0%,.15.3% and 55.6% respectively before and after between neoadjuvant chemotherapy in breast cancer..There were significant correlation between the curative effect of neoadjuvant chemotherapy and changes of ER,.PR,.Ki-67.（P 0.05）..There were no significant correlation between HER2 and curative effect of neoadjuvant chemotherapy.Conclusion The ER,PR,.HER2 and Ki-67 expressions show significant changes after neoadjuvant chemotherapy in breast cancer.ER,PR and Ki-67 would predict the curative effects of neoadjuvant chemotherapy.