ER、PR、HER-2、Ki-67与乳腺癌新辅助化疗疗效相关性分析

目的  探讨雌激素受体（ER）、孕激素受体（PR）、人表皮生长因子受体2（HER-2）、Ki67抗原（Ki-67）与乳腺癌新辅助化疗疗效相关性分析。方法  采用免疫组织化学方法检测81例乳腺癌新辅助化疗前后ER、PR、HER-2、Ki-67的表达情况，并评估其与乳腺癌新辅助化疗有效率的关系。结果  81例患者中临床RR79％，术后pCR（9.9％），tpCR（6.2％）。达到pCR+tpCR率，（ER阴性）23.0%>（ER阳性）12.7%，（PR阴性）28.6%>（PR阳性）9.4%；ER、PR、HER-2及Ki67等与新辅助化疗疗效之间差异无统计学意义。新辅助化疗前后ER、PR、HER-2的状态改变不明显，差异无统计学意义（P >0.05），而Ki67的表达数量有统计学意义（P <0.05），其降低了Ki67的表达水平。结论  乳腺癌新辅助化疗可有效控制肿瘤，ER或PR阴性者较阳性者可获得更高的pCR+tpCR率，Ki67可作为化疗药物敏感性和耐药性的预测指标。

Relationship between expressions of ER, PR, HER-2, Ki-67 and effective rate of neoadjuvant chemotherapy of breast cancer

Objective To investigate the relationship between expressions of ER, PR, HER-2 and Ki-67 and the effective rate of neoadjuvant chemotherapy of breast cancer, and to investigate the predictive index on neoadjuvant chemotherapy for breast cancer. Methods Expressions of ER, PR, HER-2 and Ki-67 in breast cancer of 81 patients received neoadjuvant chemotherapy were detected by immunohistochemical method before and after chemotherapy. The relationships of expression levels and the effective rate were evaluated. Results The clinical RR in 81 patients was 79%, pCR after surgery was 9.9%, tpCR was 6.2%. Achieved PCR+tPCR rate, (ER-negative) 23.0% > (ER-positive) 12.7%, and (PR-negative) 28.6% > (PR-positive) 9.4%. There was no statistical difference between ER, PR, HER-2 and Ki67 with neoadjuvant chemotherapy. ER, PR, HER-2 negative or positive changes were not obvious for neoadjuvant chemotherapy, and the difference was not statistically significant (P > 0.05), while the number of Ki67 expression was statistically significant (P < 0.05), which reduced the expression levels of Ki67. Conclusions Neoadjuvant chemotherapy can effectively control the tumor. ER - or PR - negative receive a high errate of pCR + tPCR comparing with those positive. Ki67 may be a predictor for chemotherapy drug sensitivity and resistance.