p63、Ki-67在乳腺浸润性导管癌中的表达及与新辅助化疗的关系  

Expression of p63 and Ki-67 in breast invasive ductal carcinoma and their relationship with efficacy of neoadjuvant chemo-therapy

作　　者：张牛牛 魏巴金[1] 李成志 傅佩芬[1] 代志军 ZHANG Niuniu;WEI Bajin;LI Chengzhi;FU Peifen;DAI Zhijun(Department of Breast Surgery,the First Affiliated Hospital of Zhejiang University School of Medicine,Hangzhou 310003,China)

机构地区：[1]浙江大学医学院附属第一医院乳腺外科,杭州310003 [2]浙江大学医学院附属第一医院病理科,杭州310003

出　　处：《浙江医学》2022年第19期2044-2048,共5页Zhejiang Medical Journal

摘　　要：目的分析乳腺浸润性导管癌患者癌组织中p63、Ki-67在新辅助化疗前后表达的变化及与新辅助化疗疗效的关系。方法选取2015年1月至2021年6月浙江大学医学院附属第一医院收治的乳腺浸润性导管癌患者202例。患者均接受新辅助化疗,并在化疗期间或化疗结束后行乳腺癌保乳根治术或改良根治术。采用免疫组化染色法检测患者术前穿刺及术后切除标本中癌组织p63、Ki-67表达情况,分析其与患者临床病理特征的关系,及新辅助化疗前后表达的变化与疗效的关系。结果新辅助化疗前患者乳腺癌组织p63表达情况与淋巴结转移有关(P<0.05),Ki-67表达情况与分子分型有关(P<0.05)。患者乳腺癌组织p63表达阳性率由化疗前的11.4%上升到化疗后的40.4%。患者乳腺癌组织Ki-67低表达率由化疗前的9.0%上升到化疗后的46.3%。化疗后乳腺癌组织p63表达阴性转阳性的患者术后病理完全缓解率(59.5%)>p63表达阳性不变的患者(44.4%)>p63表达阴性不变的患者(6.3%)>p63表达阳性转阴性的患者(0.0%)(均P<0.05)。化疗后乳腺癌组织p63表达阴性转阳性的患者区域淋巴结阳性转阴性率(72.4%)>p63表达阳性不变患者(50.0%)>p63表达阴性不变患者(28.8%)>p63表达阳性转阴性患者(25.0%)(均P<0.05)。结论在乳腺浸润性导管癌中,p63表达阳性患者区域淋巴结转移率低,新辅助化疗后pCR率高。新辅助化疗后p63表达阳性患者能够获得更好的预后。Ki-67高表达患者对化疗更敏感。Objective To analyze the expression of p63 and Ki 67 in breast invasive ductal carcinoma and its relationship with the efficacy of neoadjuvant chemotherapy.Methods A total of 202 patients with invasive ductal carcinoma admitted in the First Affiliated Hospital of Zhejiang University School of Medicine from January 2015 to June 2021 were enrolled.All patients received modified radical mastectomy or breast conserving surgery during chemotherapy or after chemotherapy.Immunohistochemical staining was used to detect the expression of p63 and Ki 67 in cancer tissues.The relationship of p63 and Ki 67 expression with clinicopathological features of patients,and the efficacy of neoadjuvant chemotherapy was analyzed.Results The expression of p63 in breast cancer was significantly associated with lymph node metastasis(P<0.05),and the expression of Ki 67 was associated with molecular typing of breast cancer(P<0.05).The positive rate of p63 expression in breast cancer increased from 11.4%before chemotherapy to 40.4%after chemotherapy;the expression rate of Ki 67 increased from 9.0%before chemotherapy to 46.3%after chemotherapy.After chemotherapy,the pathological complete remission rates of patients with p63 expression converted from negative to positive,remained positive,remained negative and converted from positive to negative were 59.5%,44.4%,6.3%and 0.0%,respectively(P<0.05).After chemotherapy,the negative conversion rates of metastatic regional lymph nodes in patients with p63 expression converted from negative to positive,remaining positive,remaining negative and concerted from positive to negative were 72.4%,50.0%,28.8%and 25.0%,respectively(P<0.05).Conclusion The regional lymph node metastasis rate in breast invasive ductal carcinoma patients with p63 positive expression is low,and the pathological complete remission rate is high after neoadjuvant chemotherapy.Patients with positive p63 expression after neoadjuvant chemotherapy may have better prognosis,while patients with high expression of Ki-67 are more sensitive to

关 键 词：乳腺癌 新辅助化疗 P63 KI-67 病理完全缓解 

分 类 号：R737.9[医药卫生—肿瘤]