Ki-67、CDK4表达与中晚期乳腺癌新辅助化疗效果的相关性分析

目的:分析Ki-67核抗原(Ki-67)、CDK4表达与中晚期乳腺癌新辅助化疗(NACT)效果的相关性。方法:回顾性选取2016年4月至2018年6月我院的中晚期乳腺癌患者70例,均于新辅助化疗后实施手术,依据化疗效果分为有效组、无效组,采用免疫组化法检测两组化疗前Ki-67、CDK4表达水平,比较不同Ki-67、CDK4表达水平患者病理完全缓解率(pCR)、2年复发转移情况。结果:有效组Ki-67高表达率、CDK4阳性率高于无效组(P<0.05);Ki-67高表达患者pCR率高于Ki-67低表达者,CDK4高表达者pCR率高于CDK4低表达者(P<0.05);Kaplan-Meier曲线显示,Ki-67低表达的乳腺癌患者2年复发转移率低于Ki-67高表达者(P<0.05),CDK4高表达的乳腺癌患者2年复发转移率与CDK4低表达者无明显差异(P>0.05);Spearman相关分析显示,乳腺癌患者Ki-67、CDK4表达变化与化疗效果呈正相关(r=0.569、0.481,P<0.05)。结论:Ki-67、CDK4高表达的乳腺癌患者经NACT后获得pCR率更高,化疗疗效更优,但Ki-67高表达者预后较差,CDK4表达情况与预后相关性不大。

Correlation analysis of the expression of Ki-67 and CDK4 and effect of neoadjuvant chemotherapy for advanced breast cancer

Objective:To analyze the relationship between the expression of Ki-67 nuclear antigen (Ki-67) and CDK4 and effect of neoadjuvant chemotherapy (NACT) for advanced breast cancer.Methods:A retrospective study was conducted among 70 patients with advanced breast cancer who underwent operation after NACT in the hospital between April 2016 and June 2018.According to the effect of chemotherapy,the patients were divided into effective group and ineffective group.The expression levels of Ki-67 and CDK4 in both groups before chemotherapy were detected by immunohistochemistry.The pathological complete response (pCR) and 2-year recurrence and metastasis rates of patients with different expression levels of Ki-67 and CDK4 were compared.Results:The Ki-67 high expression rate,CDK4 positive rate in the effective group were higher than those in the ineffective group (P＜0.05).The pCR rate of patients with high Ki-67 expression was higher than those with low Ki-67 expression,and the pCR rate of patients with high CDK4 expression was higher than those with low CDK4 expression (P＜0.05).Kaplan-Meier curve showed that in breast cancer patients,the 2-year recurrence and metastasis rates of patients with low Ki-67 expression were lower than those with high Ki-67 expression (P＜0.05).However,no significant differences were found in 2-year recurrence and metastasis rates between patients with high and low CDK4 expression (P＞0.05).Spearman correlation analysis showed that the changes in expression of Ki-67 and CyclinD1 were positively correlated with chemotherapy effects (r=0.569,0.481,P＜0.05).Conclusion:Breast cancer patients with high Ki-67 and CDK4 expression have a higher pCR rate after NACT and better chemotherapy efficacy.However,those with high Ki-67 expression have worse prognosis.Additionally,CDK4 expression has little relationship with the prognosis.