新辅助化疗对乳腺癌生物学指标表达的影响

目的 探讨新辅助化疗对评估原发性乳腺癌空心针穿刺活检（CNB）和手术切除标本（SES）生物学指标的影响.方法 152 例原发性乳腺癌患者纳入本研究.其中化疗组99 例,手术组53 例.采用免疫组织化学（IHC）方法 比较152 例CNB 和SES 采样组织标本中雌激素受体（ER）、孕激素受体（PR）、人表皮生长因子2（Her2）、Ki67、p53 和TopoⅡ的表达,评估CNB 在乳腺癌生物学指标检测中的准确性.结果 CNB 和SES 在评估是否接受过新辅助化疗乳腺癌生物学指标方面具有良好的一致性,K 值〉 0.6.手术组CNB 对生物学指标评估的准确性达到87% ~ 91%,化疗组的准确性78% ~ 95%.但新辅助化疗对ER、PR、Her2、p53 和Ki67 表达的影响差异无统计学意义（P 〉 0.05）,两组间比较TopoⅡ表达差异有统计学意义（P 〈 0.05）.结论 CNB 和SES 在评估乳腺癌生物学指标上的一致性较好,CNB 评估乳腺癌生物学指标的准确性高.新辅助化疗对乳腺癌生物学指标的影响较小.

Effect of neoadjuvant chemotherapy on expression of biological markers in breast cancer

Objective To determine the accuracy of biological markers expression in core needle biopsies （CNB） compared with surgically excised specimens （SES） and the influence of preoperative chemotherapy on these markers expression. Methods One hundred and fifty-two of 170 patients were analyzed. Ninty-nine women received neoadjuvant chemotherapy, and 53 patients underwent immediate surgery. Estrogen （ER） and progesterone receptor （PR）, Her2, Ki67, p53 and Topo ]I in biopsy tissue and surgically removed specimens were assessed using immunohistochemistry staining and calculated accuracy and kappa value. Results The assessment of biological markers expression can be performed on CNB and correlated well with subsequent SES regardless of patients with or without preoperative chemotherapy （K 〉 0.6）, although the concordance rate in patients without preoperative chemotherapy was found to be higher for biomarkers expression compared to women with preoperative chemotherapy. The accuracy of CNB was 87%- 91% in patients without neoadjuvant, and 78% - 95% with neoadjuvant. No significant deference was observed about the effect of neoadjuvant chemotherapy on ER, PR, Her2, Ki67and p53, except Topo II. Conclusions The agreement of breast cancer biomarkers expression detected in CNB and SES is high. The accuracy of biomarkers measurement in CNB is good. The effect of neoadjuvant chemotherapy on biological markers is small.