临床研究(Clinical Research)

新辅助化疗后Ki-67表达变化对乳腺癌预后的影响及其与分子分型的关系

Published at: 2016年第25卷第5期

蒋程凤 1 , 迪力夏提·金斯汗 1 , 吐鲁洪·沙列尔 1
1 新疆医科大学附属肿瘤医院 乳腺外科一病区,新疆 乌鲁木齐 830011
通讯作者 沙列尔 吐鲁洪· Email: tuerhong666@126.com
DOI: 10.3978/j.issn.1005-6947.10.3978/j.issn.1005-6947.2016.05.015
基金:

摘要

目的:探讨新辅助化疗(NCT)后Ki-67表达改变对乳腺癌预后的影响及与分子分型的关系。方法:回顾2010—2013年收治的121例接受NCT的IIA~IIIC期乳腺癌患者资料,分析NCT后Ki-67表达变化与乳腺癌预后的关系以及其在不同分子分型中的差异。结果:NCT前Ki-67表达与患者肿瘤大小(r=0.181,P=0.047)、组织学分级(r=0.340,P<0.001)及HER-2表达(r=0.335,P<0.001)呈正相关。全组患者3年无病生存率(DFS)为73.4%,其中NCT后Ki-67减少、增加、不变患者中3年DFS分别为82.6%、61.1%、68.4%,差异有统计学意义(P=0.034);而不同分子亚型3年DSF分别为Luminal A型70.7%、Luminal B型71.4%、HER-2阳性型80.7%、基底样型(78.7%),4组间差异无统计学意义(P=0.857)。族别、治疗前HER-2状态、病理腋窝淋巴结及NCT前后Ki-67表达改变是乳腺癌患者DFS的独立影响因素(均P<0.05)。结论:乳腺癌NCT后Ki-67的变化是乳腺癌患者DFS的独立影响因素,但其变化的影响与乳腺癌的分子分型无明显关系。


Influence of change of Ki-67 expression after neoadjuvant chemotherapy on prognosis of breast cancer and its relation with molecular subtypes

Abstract

Objective: To investigate the impact of the change of Ki-67 expression after neoadjuvant chemotherapy (NCT) on prognosis of breast cancer and its relation with the breast cancer molecular subtypes. Methods: The clinical data of 121 patients with stage IIA-IIIC breast cancer undergoing NCT from 2010 to 2013 were reviewed. The relationship between the change of Ki-67 expression after NCT and prognosis of breast cancer as well as the difference of Ki-67 change among different molecular subtypes were analyzed. Results: Ki-67 expression before NCT was positively correlated to tumor size (r=0.181, P=0.047), histological grade (r=0.340, P<0.001) and HER-2 expression (r=0.335, P<0.001) of the patients. The 3-year disease-free survival (DFS) was 73.4%, which in patients with reduced, increased and unchanged Ki-67 expression after NCT was 82.6%, 61.1% and 68.4% respectively, and the difference was statistically significant (P=0.034), while among patients with different molecular subtypes was 70.7% for luminal A, 71.4% for luminal B, 80.7% for HER-2 positive, and 78.7% for basal like, and the difference had no statistical significance (P=0.857). Nationality, pre-treatment of HER-2 status, and pathologic axillary lymph node and change of Ki-67 expression after NCT were the independent influential factors for DFS of breast cancer patients (all P<0.05). Conclusion: The change of Ki-67 expression after NCT is an independent influential factor for DFS in breast cancer patients, but its change shows no obvious relation with breast cancer molecular subtypes.


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引用

引用本文: 程凤 蒋, 金斯汗 迪力夏提·, 沙列尔 吐鲁洪·. 新辅助化疗后Ki-67表达变化对乳腺癌预后的影响及其与分子分型的关系[J]. 中国普通外科杂志, 2016, 25(5): 711-716.
Cite this article as: JIANG Chengfeng, DILIXIATI• Jinsihan, TULUHONG• Shalieer . Influence of change of Ki-67 expression after neoadjuvant chemotherapy on prognosis of breast cancer and its relation with molecular subtypes[J]. Chin J Gen Surg, 2016, 25(5): 711-716.