SUVmax、Ki-67、p53、EGFR对三阴性乳腺癌新辅助化疗疗效的预测价值

目的 探讨18F-FDG PET/CT化疗前SUVmax、Ki-67、p53、EGFR对三阴性乳腺癌（TNBC）及非三阴性乳腺癌（非TNBC）对新辅助化疗完全病理缓解（pathologic complete response, pCR）率的预测价值。方法 初治TNBC患者27例，非TNBC患者184例，在新辅助化疗前行18F-FDG PET/CT显像并测量其SUVmax，取化疗前乳腺肿瘤组织进行Ki-67、p53、EGFR免疫组织化学分析并计算化疗后完全pCR率。结果 TNBC新辅助化疗前的SUVmax明显高于非TNBC的SUVmax（P=0.045），TNBC新辅助化疗后pCR率明显高于非TNBC（P＜0.001）。在TNBC以及非TNBC中，达到pCR组的化疗前SUVmax与未达到pCR组之间差异无统计学意义（P＞0.05）。Ki-67、p53、EGFR阳性表达组的pCR率与阴性表达组之间差异无统计学意义（P＞0.05）。结论 TNBC对新辅助化疗的敏感度高于非TNBC，且TNBC化疗前SUVmax高于非TNBC，提示TNBC具有较高的能量代谢。化疗前SUVmax以及Ki-67、p53、EGFR不能预测TNBC及非TNBC新辅助化疗的pCR。

Valuation of SUVmax,Ki-67, p53 and EGFR in Predicting Effect of Neoadjuvant Chemotherapy on Triple-negative Breast Cancer Patients

Objective To compare the value of 18F-FDG PET/CT SUVmax before neoadjuvant chemotherapy, Ki-67, p53 and EGFR in predicting pathologic complete response(pCR) after neoadjuvant chemotherapy between triple-negative breast cancer(TNBC) and non-TNBC patients. Methods Twenty-seven cases were newly diagnosed TNBC patients and 184 cases were non-TNBC. 18F-FDG PET/CT was performed before neoadjuvant chemotherapy to measure the SUVmax. Before neoadjuvant chemotherapy, we took immumohistochemical examination of Ki-67, p53 and EGFR in breast cancer tissues and calculated the rate of pathologic complete response (pCR). Results SUVmax before neoadjuvant chemotherapy in TNBC patients was higher than that in non-TNBC patients(P=0.045); the pCR rate in TNBC patients was obviously higher than that in non-TNBC patients(P<0.001). In TNBC and non-TNBC patients, there was no statistical difference in SUVmax between achieved pCR group and non-achieved pCR group(P>0.05). There was no statistical difference in pCR rate between Ki-67, p53, EGFR positive groups and the negative groups (P>0.05). Conclusion TNBC is more sensitive than non-TNBC to neoadjuvant chemotherapy, and SUVmax before neoadjuvant chemotherapy in TNBC patients is higher than that in non-TNBC patients, which means TNBC has a higher metabolism. SUVmax, Ki-67, p53 and EGFR couldn’t predict the pCR of TNBC or non-TNBC with neoadjuvant chemotherapy.