摘要
目的探讨雌激素受体(ER)、乳激素受体(PR)、Ki-67抗原(Ki-67)、人类表皮生长因子受体-2(Her-2)在乳腺癌新辅助化学治疗(NAC)前后的表达及意义。方法选取2014年6月至2016年1月黄骅市人民医院收治的乳腺癌患者70例为研究对象,患者手术前均行新辅助化学治疗(NAC),NAC前在彩色超声引导下行空芯针穿刺活检,采用免疫组织化学法测定ER、PR、Ki-67、Her-2的表达,手术后采用免疫组织化学法测定切除标本中ER、PR、Ki-67、Her-2的表达,观察乳腺癌患者NAC的临床疗效、乳腺癌组织中ER、PR、Ki-67、Her-2表达与疗效的关系以及NAC前后乳腺癌组织中ER、PR、Ki-67、Her-2表达情况。结果 70例乳腺癌患者在完成NAC后,完全缓解和部分缓解患者达78.57%(55/70),病情稳定为21.43%(15/70),未出现疾病进展患者。NAC后,乳腺癌患者ER阳性者有效率为89.58%(43/48),显著高于ER阳性者有效率54.55%(12/22)(χ2=9.02,P<0.05);PR阴性者有效率为84.62%(33/39),与PR阳性者有效率70.97%(22/31)比较差异无统计学意义(χ2=1.91,P>0.05);Ki-67阴性者有效率为64.52%(20/31),显著低于Ki-67阳性者有效率89.74%(35/39)(χ2=6.53,P<0.05);Her-2非过表达者有效率为83.87%(26/31),与Her-2过表达者有效率74.36%(29/39)比较差异无统计学意义(χ2=0.93,P>0.05)。70例乳腺癌患者接受NAC后Ki-67阳性率较NAC前显著降低(P<0.05),而ER、PR、Her-2表达NAC前后比较差异无统计学意义(P>0.05)。结论乳腺癌患者NAC前ER、Ki-67表达可预测NAC的临床效果,而PR、Her-2的表达与NAC的治疗效果无关;NAC可降低Ki-67表达水平。
Objective To explore the expressions and significance of estrogen receptor（ ER）,progestin recetor（ PR）,nuclcar-associated antigen（ Ki-67）,and human epidermal growth factor receptor 2（ Her-2） before and after neoadjuvant chemotherapy（ NAC） in patients with breast cancer. Methods A total of 70 patients with breast cancer who were admitted in the People＇s Hospital of Huanghua City from June 2014 to January 2016 were selected as subjects. All the patients were given NAC before operation. The ultrasound-guided core needle biopsy was performed before NAC and the expressions of ER,PR,Ki-67,and Her-2 were determined. The immunohistochemistry was used to detect the expressions of ER,PR,Ki-67,and Her-2 in the resection specimens after operation. The clinical efficacy after NAC,the correlation of ER,PR,Ki-67,and Her-2 expressions with the curative effect,and the expressions of ER,PR,Ki-67,and Her-2 in the breast cancer tissues before and after NAC were observed. Results After NAC,the total effective rate was 78. 57%（ 55 /70）,stable disease（ SD） was 21. 43%（ 15 /70）,and no progression of disease（ PD） cases occurred. The effective rate in patients with negative ER（ 89. 58%,43 /48） was significantly higher than that in patients with positive ER（ 54. 55%,12 /22）（ χ2= 9. 02,P 0. 05）. The effective rate in patients with negative PR and positive PR was 84. 62%（ 33 /39） and 70. 97%（ 22 /31） respectively; there was no statistic difference in the effective rate between the negative PR patients and positive PR patients（ χ2= 1. 91,P 0. 05）. The effective rate in patients with negative Ki-67（ 64. 52%,20 /31） was significantly lower than that in patients with positive Ki-67（ 9. 74%,35 /39）（ χ2= 6. 53,P 0. 05）. The effective rate in patients with negative Her-2 and positive Her-2 was 83. 87%（ 26 /31） and74. 36%（ 29 /39） respectively; there was no statistic difference in the effective rate between the negative Her-2 patients and positive Her-2 patients（ χ2= 0. 93,P 0. 05）. The positive rate of Ki-67 in the other 70 patients after NAC was significantly lower than before NAC（ P 0. 05）,while the expressions of ER,PR,and Her-2 were not significantly changed before and after NAC（ P 0. 05）. Conclusion The expressions of ER and Ki-67 in patients with breast cancer before NAC can predict the clinical effect of NAC,while the expressions of PR and Her-2 are not correlated with the clinical effect of NAC. NAC can reduce the expression level of Ki-67.
作者
杨绍英
刘朝荣
张志刚
宋金河
王金树
YANG Shao-ying LIU Chao-rong ZHANG Zhi-gang SONG Jin-he WANG Jin-shul(Department of Pathology, the People＇s Hospital of Huanghua City, Huanghua 061100, Hebei Province, China Department of Pathology, the People＇s Hospital of Cangzhou City, Cangzhou 061000, Hebei Province, China)
出处
《新乡医学院学报》
CAS
2017年第2期125-128,共4页
Journal of Xinxiang Medical University
基金
沧州市科技支撑计划项目(编号:151302193)
