Ki-67表达对AC-T方案新辅助化疗治疗局部晚期乳腺癌临床效果的影响  

The effect of Ki--67 expression on the clinical efficacy of neoadjuvant chemotherapy with AC--T chemo-therapy for locally advanced breast cancer

作　　者：陈大琴[1] 曹勇[2] 郑晓东[2] 辇伟奇[2] 曾晓华[2] 刘晓渝[2] CHEN Da-qin;CAO Yong;ZHENG Xiao-dong;NIAN Wei-qi;ZENG Xiao-hua;LIU Xiao-yu(Department of Clinical Laboratory, Chongqing Cancer Institute & Hospital & Cancer Center, Chongqing 400030,China;Department of Breast center, Chongqing Cancer Institute & Hospital & Cancer Center, Chongqing 400030, China)

机构地区：[1]重庆市肿瘤研究所/医院/癌症中心检验科,重庆400030 [2]重庆市肿瘤研究所/医院/癌症中心乳腺中心,重庆400030

出　　处：《中国医学前沿杂志（电子版）》2017年第6期104-108,共5页Chinese Journal of the Frontiers of Medical Science(Electronic Version)

摘　　要：目的分析Ki-67表达对吡柔比星、环磷酰胺序贯多西他赛(AC-T)方案新辅助化疗治疗局部晚期乳腺癌(Locally advanced breast cancer,LABC)临床效果的影响,为早期预测新辅助化疗效果提供参考。方法选取本院2013年2月至2016年2月收治的233例LABC患者为研究对象,所有患者均采用AC-T方案实施新辅助化疗,按照患者化疗后是否达到病理完全缓解(pathological complate response,pCR)将其分为pCR组和非pCR组,比较两组患者一般资料和病灶组织Ki-67表达的差异,分析LABC患者临床效果的影响因素,并检测其化疗前后病灶组织Ki-67表达变化。结果 233例患者中,完全缓解122例(其中pCR 53例),部分缓解83例,疾病稳定15例,疾病进展13例,总有效率为87.98%,保乳率为12.88%(30/233)。多因素分析结果显示,人类表皮生长因子受体2过表达、化疗前Ki-67高表达是影响LABC化疗效果的保护因素(P<0.05)。与化疗前比较,两组患者化疗后Ki-67高表达率均有所降低,但非pCR组患者化疗后Ki-67高表达率显著低于pCR组(P<0.05)。结论AC-T方案新辅助化疗治疗LABC的临床效果受乳腺癌分子分型和Ki-67表达的影响,Ki-67高表达提示患者预后较佳,但化疗后患者Ki-67高表达率呈下降趋势,其具体机制有待进一步探讨。Objective To investigate the effect of Ki-67expression on the clinical efficacy of neoadjuvant chemotherapy with pirarubicin and cyclophosphamide sequential docetaxel(AC-T)chemotherapy for locally advanced breast cancer(LABC),and to provide a reference for early prediction of neoadjuvant chemotherapy.Method233cases of patients with LABC admitted in our hospital from February2013to February2016were selected as the research objects.All patients were treated with AC-T regimen neoadjuvant chemotherapy,according to whether the patients getting pathological complete remission(pCR)after chemotherapy,they were divided into pCR group and non-pCR group.The general information and Ki-67expression in lesion tissue were compared to analyse the factors influencing the clinical effect of LABC patients,and detected the changes of the expression of Ki-67in lesion tissues before and after chemotherapy.Result In233cases,122cases of patients wtih complete response(including53cases wirth pCR),83cases with partial response,15cases with stable disease,13cases with rogressive disease,total effective rate was87.98%,breast conserving rate was12.88%(30/233).Multivariate analysis showed that over expression of HER-2molecular classification and high expression of Ki-67before chemotherapy were protective factors affecting the efficacy of chemotherapy in LABC(P<0.05).Compared with before chemotherapy,high expression rate of Ki-67in both pCR group and non-pCR group all decreased,but the positive rate of Ki-67in non-pCR group was significantly lower than that in pCR group(P<0.05).Conclusion The clinical effect of AC-T regimen neoadjuvant chemotherapy for LABC patients is affected by molecular type and the expression of Ki-67.High expression of Ki-67in patients means a better prognosis.But Ki-67high expression rate decreases after chemotherapy,and the specific mechanism needs to be further discussed.

关 键 词：KI-67 AC-T方案 新辅助化疗 局部晚期乳腺癌 

分 类 号：R737.9[医药卫生—肿瘤]