激素受体和Ki67的表达与乳腺癌蒽环类新辅助化疗疗效的相关性  

Association between hormone receptors and response to neoadjuvant anthracycline-based chemotherapy in breast cancer patients

作　　者：卫燕[1] 李金峰[1] 王天峰[1] 解云涛[1] 范照青[1] 范铁[1] 陆爱萍[2] 欧阳涛[1] 林本耀[1] 

机构地区：[1]北京大学临床肿瘤学院,北京肿瘤医院暨北京市肿瘤防治研究所乳腺癌预防治疗中心,北京100036 [2]北京大学临床肿瘤学院,北京肿瘤医院暨北京市肿瘤防治研究所病理科,北京100036

出　　处：《北京大学学报（医学版）》2007年第5期481-483,共3页Journal of Peking University:Health Sciences

基　　金：北京市卫生局重点学科基金资助项目(1998卫科重字10号)~~

摘　　要：目的:探讨激素受体和增殖相关抗原Ki67的表达与乳腺癌蒽环类新辅助化疗疗效之间的相关性。方法:采用免疫组化方法检测168例乳腺癌患者接受蒽环类新辅助化疗前肿瘤组织中雌激素受体(estrogen receptor,ER)、孕激素受体(progesterone receptor,PR)和Ki67的表达水平并探讨它们与病理疗效之间的相关性。结果:全组病理有效率(G4+G5)为40%(67/168),病理完全缓解(pCR)率为20%(33/168)。PR阴性组与阳性组比较,在病理有效率和pCR率方面差异均有统计学意义(17/67vs45/90,P=0.002;6/67vs25/90,P=0.003)。ER阴性组与阳性组比较,仅病理有效率方面差异有统计学意义(19/64vs43/98,P=0.04)。联合ER和PR状态分析显示,ER和PR双阴性在病理有效率方面较其他表达组差异有统计学意义(36/71vs26/86,P=0.009)。未发现Ki67表达与病理有效率和pCR率之间有相关性。ER,PR和Ki67表达均与化疗疗效呈线性趋势。结论:激素受体状况与乳腺癌蒽环类新辅助化疗疗效相关,其中PR阴性者对化疗更为敏感。Objective：To investigate the associations between the hormone receptors,Ki67 expression and response to neoadjuvant anthracycline-based chemotherapy in breast cancer patients.Methods：One hundred sixty-eight primary breast cancer patients received anthracycline-based neoadjuvant chemotherapy.The expression of estrogen receptor（ER）,progesterone receptor（PR）,and Ki67 were determined by immunohistochemistry assay in core-needle biopsy specimens prior to the chemotherapy,and pathologic response was assessed by Miller ＆ Payne grade（G1 to G5）.Results：40%（67/168）of the patients had a good pathologic response,defined as complete pathologic response（pCR or G5）and minimal residual disease（G4）.Among the patients,20%（33/168）had a complete pathologic response（G5）.ER or PR status was significantly associated with pathological response.Patients with PR-negative tumors had a higher pathological response rate or pCR than those with PR-positive tumors（17/67 vs 45/90,P=0.002;6/67 vs 25/90,P=0.003,respectively）,whereas patients with ER-negative tumors had a higher pathological response rate than those with ER-positive tumors.Moreover,Patients with both ER-and PR-negative tumors exhibited a remarkable pathological response as compared with those with any single factor（36/17 vs 26/86,P=0.009）.No association between Ki67 expression and pathological was found in this cohort of patients.There was a linear correlation between the expression of Ki-67,ER or PR status and pathologic response.Conclusion：There is a significant association between the hormone receptors and pathological response to neoadjvant anthracycline-based chemotherapy in breast cancer patients,and patients with PR-negative tumors are more likely to respond to chemotherapy.

关 键 词：乳腺肿瘤 蒽环类 化学疗法 辅助 受体 雌激素 KI67抗原 

分 类 号：R737.9[医药卫生—肿瘤]