新辅助化疗后Ki-67表达变化及其与乳腺癌患者预后的关系  

Change of Ki-67 expression before and after neoadjuvant chemotherapy and its relation with prognosis of breast cancer patients

作　　者：陈萌[1] 路洪超[2] 刘铄[1] CHEN Meng;LU Hong-chao;LIU Shuo(Department of General Surgery,Civil Affair General Hospital of Hebei Province,Xingtai 054000,China;Center of Breast,the Fourth Hospital of Hebei Medical University,Shijiazhuang 051000,China)

机构地区：[1]河北省民政总医院普通外科,邢台市054000 [2]河北医科大学第四医院乳腺中心,石家庄市051000

出　　处：《广西医学》2019年第21期2697-2700,2718,共5页Guangxi Medical Journal

摘　　要：目的探讨新辅助化疗后Ki-67表达变化及其与乳腺癌患者无复发生存(RFS)的关系。方法纳入185例初治乳腺癌患者,均行新辅助化疗治疗。化疗前及化疗4个周期后,采用免疫组织化学法检测患者乳腺癌组织Ki-67的表达情况。在185例乳腺癌患者以及不同分子分型患者中,比较化疗前后Ki-67的表达情况,并比较Ki-67表达降低者与未降低者的RFS。结果化疗后,总体185例乳腺癌患者以及其中Luminal B型、三阴性型、人表皮生长因子受体2(HER-2)过表达型患者的Ki-67表达水平均较化疗前降低(均P<0.05),且其Ki-67表达降低者的RFS率均高于未降低者(均P<0.05)。但对于Luminal A型患者,化疗前后Ki-67表达水平差异无统计学意义,且Ki-67降低者与未降低者间RFS率差异亦无统计学意义(均P>0.05)。结论乳腺癌患者,尤其是Luminal B型、三阴性型和HER2过表达型乳腺癌患者,新辅助化疗后Ki-67表达水平降低,可能是其预后较好的生物学指标。Objective To explore the change of Ki-67 expression before and after neoadjuvant chemotherapy,and the relationship of the change with relapse-free survival(RFS) of patients with breast cancer.Methods A total of 185 breast cancer patients receiving initial therapy were enrolled,and were all treated with neoadjuvant chemotherapy.Before chemotherapy and after 4 cycles of chemotherapy,the expression of Ki-67 in breast cancer tissues was detected by immunohistochemistry.In 185 breast cancer patients and the patients with different molecular types,the expression of Ki-67 before and after chemotherapy was compared;besides,the RFS was compared between the patients with low-expression of Ki-67 and without low-expression of Ki-67.Results Compared to pre-chemotherapy,the Ki-67 expressions after chemotherapy decreased in all 185 breast cancer patients,as well as the patients with Luminal B type,triple negative type or human epidermal growth factor receptor-2(HER-2) over-expression type(all P<0.05),and the RFS rate of the patients with low-expression of Ki-67 was higher than that of the patients without low-expression of Ki-67(all P<0.05).However,in allusion to patients with Luminal A,no statistically significant difference was found between the Ki-67 expressions before and after chemotherapy,and there was also no statistically significant difference in the RFS between the patients with low-expression of Ki-67 and without low-expression of Ki-67(all P>0.05).Conclusion The Ki-67 expression decreases after neoadjuvant chemotherapy in the breast cancer patients,especially in the breast cancer patients with Luminal B type,triple negative type and HER-2 over-expression type,and it may be a preferable biological index for patients′ prognosis.

关 键 词：乳腺癌 KI-67 新辅助化疗 分子分型 无复发生存率 预后 

分 类 号：R737.7[医药卫生—肿瘤]