文章摘要

乳腺癌患者Ki-67表达水平对新辅助化疗后病理学完全缓解的预测价值

作者: 1刘 杰娜, 1张 建国, 1郭 宝良, 1陈 晰, 1于 玺文, 1王 卓众, 1柳 林
1 哈尔滨医科大学附属第二医院 乳腺外科,黑龙江 哈尔滨150081
通讯: 柳 林 Email: 41014203@qq.com
DOI: 10.3978/.2018.05.013
基金: 国家自然科学基金资助项目(81372838)。

摘要

目的:探讨乳腺癌患者Ki-67表达水平对新辅助化疗(NAC)疗效的影响。
方法:收集261例行NAC且临床病理资料相对完整的乳腺癌患者,分析患者Ki-67表达以及其他临床病理因素包括分子分型、激素受体状态等与患者NAC后病理学完全缓解(pCR)的关系。
结果:单因素分析结果显示,患者NAC后pCR与孕激素受体(PR)及表皮生长因子受体2(Her-2)状态、分子分型与Ki-67水平明显有关(均P<0.05);多因素分析显示,Ki-67表达水平是NAC后pCR独立预测因素(OR=5.476,95% CI=2.637~11.372,P<0.05)。此外,在雌激素受体(ER)阳性患者中,Ki-67高表达患者pCR率为低表达患者的4.282倍(OR=4.282,95% CI=1.694~10.825,P=0.002),而PR阳性患者pCR率为阴性患者的0.303倍(OR=0.303,95% CI=0.113~0.810,P=0.017),Her-2阳性者的pCR率是Her-2阴性者的2.607倍(OR=2.607,95% CI=1.023~6.642,P=0.045)。
结论:乳腺癌患者Ki-67高表达是NAC后高pCR率的预测因子,同时结合其他激素受体状态,将有助于更好的指导个体化NAC。
关键词: 乳腺肿瘤;放化疗,辅助;前导性化疗;生物标记,肿瘤

Values of Ki-67 expression level in predicting pathological complete response following neoadjuvant chemotherapy in breast cancer patients

Authors: 1LIU Jiena, 1ZHANG Jianguo, 1GUO Baoliang, 1CHEN Xi, 1YU Xiwen, 1WANG Zhuozhong, 1LIU Lin
1 Department of Breast Surgery, the Second Affiliated Hospital, Harbin Medical University, Harbin 150081, China

CorrespondingAuthor:LIU Lin Email: 41014203@qq.com

Abstract

Objective: To investigate the impact of Ki-67 expression level on efficacy of neoadjuvant chemotherapy (NAC) in breast cancer patients.
Methods: A total of 261 patients with relatively complete clinicopathologic data undergoing NAC were collected. The relations of pathological complete response (pCR) after NAC with Ki-67 expression and other clinicopathologic factors such as molecular subtype and hormone receptor status of the patients were analyzed.
Results: The results of univariate analysis showed that pCR after NAC of the patients was significantly related to the status of progestrone receptor (PR) and epidermal growth factor receptor 2 (Her-2) as well as molecular subtype and Ki-67 expression; the results of multivariate analysis revealed that only the Ki-67 expression level was the independent predictive factor for pCR after NAC (OR=5.476, 95% CI=2.637–11.372, P<0.05). In addition, among the patients with positive estrogen receptor (ER) expression, the pCR rate in cases with high Ki-67 expression was 4.282-fold of that in those with low Ki-67 expression (OR=4.282, 95% CI=1.694–10.825, P=0.002), in PR positive cases was 0.303-fold of that in PR negative ones (OR=0.303, 95% CI=0.113–0.810, P=0.017), and in Her-2 positive cases was 2.607-fold of that in their negative counterparts (OR=2.607,
95% CI=1.023–6.642, P=0.045).
Conclusion: In breast cancer patients, high Ki-67 expression level is a predictive indicator for high pCR rate after NAC. Meanwhile, it may be helpful for better individualized NAC planning with combined considerations of the status of other hormone receptors.
Keywords: Breast Neoplasms; Chemoradiotherapy Adjuvant; Induction Chemotherapy; Biomarkers Tumor