Ki67指数预测Luminal型HER2-乳腺癌新辅助化疗疗效的临床价值  

Ki67 predicts response to neoadjuvant chemotherapy in Luminal subtype(HER-2 negative) of breast cancer

作　　者：桑蝶 王佳玉[1] 徐兵河[1] 张频[1] 李青[1] 袁芃[1] 马飞[1] 蔡锐刚[1] 罗扬[1] 樊英[1] 陈闪闪[1] 李俏[1] 

机构地区：[1]中国医学科学院肿瘤医院内科,北京1000210

出　　处：《癌症进展》2016年第3期251-252,255,共3页Oncology Progress

摘　　要：目的探索Ki67指数预测Luminal型HER2-乳腺癌新辅助化疗(neoadjuvant chemotherapy,NCT)疗效中的价值。方法采用免疫组织化学法检测159例NCT治疗的乳腺癌患者乳腺组织标本中Ki67、ER、PR及HER-2表达状况,用χ2检验分析Ki67与病理学完全缓解(pathological complete response,p CR)之间的关系。结果将本组病例分成两组,Ki67指数﹤30%(85例)为低表达组和Ki67指数≥30%为高表达组(74例),Ki67高表达组p CR率明显高于低表达组(21.6%vs 2.4%,P=0)。依据敏感度与特异度之和最大化原则计算Ki67预测p CR的最佳界值为37%,ROC曲线下面积为0.832,标准误为0.039,P﹤0.01。结论在Luminal型HER2-乳腺癌中,Ki67高表达患者对化疗更敏感,Ki67预测p CR的界值为37%,可作为临床医师选择治疗策略的参考依据。Objective To explore the value of Ki67 in predicting the response of neoadjuvant chemotherapy （neoad- juvant chemotherapy, NCT） in Luminal subtype （HER-2 negative） of breast cancer. Method Immunohistochemistry （IHC） was used to examine the expression of Ki67, ER, PR and HER-2 in 159 cases of breast cancers patients treated with NCT. Square analysis was applied to analyze the correlation between Ki67 expression and Pathological Complete Response （pCR）. Result Patients were divided into either lower expression group with the index of Ki67〈30% （85 cases）, or higher expression group with the index of Ki67≥30% （74 cases）. The pCR of Ki67 in the higher expression group was markedly higher than that of the lower expression group （21.6% vs 2.4%, P 〈 0.01）. Based on the sum maximum principle of sensitivity and specificity, we calculated the optimal critical value of pCR as 37%, the area under curve of ROC was 0.832, the standard error was 0.039, P 〈 0.01. Conclusion In the Luminal subtype （HER-2 negative） of breast cancer, patients with higher expression of Ki67 were more sensitive to NCT. The optimal cut-off value of Ki67 in predict- ing response is 37%, which might be a reference for clinical physicians in choosing treatment strategy.

关 键 词：Luminal型HER2-乳腺癌 KI67 新辅助化疗 疗效 ROC曲线 

分 类 号：R737.9[医药卫生—肿瘤]