Medical Oncology Department, CLCC Paul Strauss, 3 rue de la Porte de l'Hôpital BP42, 67065, Strasbourg Cedex, France.
Breast Cancer Res Treat. 2010 Nov;124(2):387-91. doi: 10.1007/s10549-010-1142-2. Epub 2010 Sep 8.
Absence of hormonal receptors (HR) expression is a predictive factor of high pathologic complete response (pCR) rate after neo-adjuvant chemotherapy. However, HR-positive tumors are less chemosensitive. In the present study, we evaluated the predictive value of estrogen (ER) and progesterone (PgR) semi-quantitative expression in patients with HR-positive tumors treated uniformly with antracycline-based neoadjuvant chemotherapy without hormonal treatment. Value of HR expression as a predictive factor was then evaluated in a multivariate analysis with tumor grade, Ki67 index and HER2 expression. From January 2000 and December 2006, 177 patients with HR-positive breast ductal invasive carcinoma ≥2 cm in its largest diameter were treated with six cycles of an anthracycline-based neo-adjuvant chemotherapy. Tumor grade, ER, PgR, HER2 status and Ki67 index were determined on microbiopsy performed before chemotherapy. A semi-quantitative evaluation of ER and PgR expression by IHC was performed using the Barnes'score. pCR rate was significantly different (P < 0.001) according to the ER expression score. pCR rate was 28% for low score, 9% for medium score and 3% for high score. On the contrary, pCR rate was not significantly different (P = 0.49) according to the PgR expression score. In the multivariate analysis, ER expression score (P = 0.0002) and Ki67 index (P = 0.02) were the only predictive factors of response for HR-positive tumors. pCR after anthracycline-based chemotherapy is significantly correlated with the ER expression score.
激素受体（HR）表达缺失是新辅助化疗后获得高病理完全缓解（pCR）率的预测因素。然而，HR 阳性肿瘤对化疗的敏感性较低。在本研究中，我们评估了 HR 阳性肿瘤患者在未接受激素治疗的情况下接受基于蒽环类的新辅助化疗时，雌激素（ER）和孕激素（PgR）半定量表达的预测价值。然后，我们用肿瘤分级、Ki67 指数和 HER2 表达的多变量分析评估了 HR 表达作为预测因子的价值。2000 年 1 月至 2006 年 12 月，177 例 HR 阳性乳腺导管浸润性癌最大直径≥2cm 的患者接受了六周期基于蒽环类的新辅助化疗。化疗前进行了微活检，确定了肿瘤分级、ER、PgR、HER2 状态和 Ki67 指数。采用免疫组织化学法（IHC）对 ER 和 PgR 表达进行半定量评估，采用 Barnes 评分。pCR 率根据 ER 表达评分有显著差异（P<0.001）。低评分的 pCR 率为 28%，中评分的 pCR 率为 9%，高评分的 pCR 率为 3%。相反，根据 PgR 表达评分，pCR 率无显著差异（P=0.49）。多变量分析显示，ER 表达评分（P=0.0002）和 Ki67 指数（P=0.02）是 HR 阳性肿瘤反应的唯一预测因素。基于蒽环类的化疗后 pCR 与 ER 表达评分显著相关。
