新辅助化疗对乳腺癌雌、孕激素受体和HER-2的影响

目的探讨新辅助化疗对乳腺癌组织中雌激素受体(ER)、孕激素受体(PR)和HER-2表达的影响。方法2001年8月~2003年12月共有92例手术的乳腺癌患者进入本研究,其中新辅助化疗者59例作为化疗组,未行新辅助化疗者33例作为对照组。分析并比较两组患者术前活检标本和术后大体标本瘤组织中ER、PR和HER-2表达和表达状态变化的差别。结果化疗组术后有37.29%(22/59)患者的ER表达出现量变,对照组为15.15%(5/33),两组比较有显著性差异(P<0.05);两组ER状态改变无显著差异。化疗组术后有23.73%(14/59)患者的PR表达出现量变,但与对照组比较无显著性差异。化疗组术后有13.56%(8/59)患者HER-2表达出现变化,但与对照组比较无显著性差异。结论新辅助化疗能使部分乳腺癌组织中ER表达发生量变,但很少影响ER状态,而新辅助化疗对乳腺癌PR和HER-2表达无影响。

Effects of neoadjuvant chemotherapy on estrogen and progesterone receptors and HER-2 in breast cancer

Objective To study the effect of neoadjuvant chemotherapy on estrogen receptor (ER), progesterone receptor (PR), and HER-2 expression in patients with breast cancer. Methods From 59 breast cancer patients treated with neoadjuvant chemotherapy and 33 without neoadjuvant therapy (control), core biopsy samples before the chemotherapy or surgery and surgical specimens were obtained for assay of ER, PR, and HER-2 expression. Results Quantitative alteration of ER expression occurred in 37.29% (22/59) of the patients after neoadjuvant chemotherapy and in 15.15% (5/33) of the control patients, showing statistically significant difference between the two groups(P<0.05), but the changes in ER expression status (conver- sion between positivity/negativity ratio) exhibited no significant difference. After the surgery, quantitative changes in PR expression was noted in 23.73% (14/59) of patients with neoadjuvant chemotherapy, without significant difference from those in the control group or changes in the expression status. Similarly, the changes in HER-2 expression seen in 13.56% (8/59) of the patients with chemotherapy was also comparable with the control group, without significant changes in the expression status. Conclusions Significant changes occur in ER receptor expression after neoadjuvant chemotherapy in patients with breast cancer, but such changes do not affect the ER status. Neoadjuvant chemotherapy has no significant effects on PR and HER-2 expression in breast cancer patients.