Osako Tomofumi, Nishimura Reiki, Okumura Yasuhiro, Toyozumi Yasuo, Arima Nobuyuki
Departments of Breast and Endocrine Surgery, and.
Exp Ther Med. 2012 Jan;3(1):66-71. doi: 10.3892/etm.2011.359. Epub 2011 Oct 3.
Estrogen receptor (ER) and progesterone receptor (PgR) status are predictive factors for the clinical and pathological response to neoadjuvant chemotherapy for operable breast cancer. However, it remains unclear as to how the proportion of ER-positive or PgR-positive tumor cells affects the response to neoadjuvant chemotherapy. We examined the correlation of the proportion of ER-positive or PgR-positive tumor cells with the clinical and pathological response to neoadjuvant chemotherapy for operable human epidermal growth factor receptor 2 (HER2)-negative breast cancer. From April 2002 to October 2010, 103 patients received neoadjuvant chemotherapy containing epirubicin and taxane in our clinic. A clinical response was observed in 86 (83%) patients, and a pathological complete response (pCR) was observed in 16 (16%) patients. Fourteen (30%) of 46 patients with ER-negative tumors achieved pCR and 15 (26%) of 57 patients with PgR-negative tumors achieved pCR. Patients with more than 30% ER-positive tumor cells or more than 1% PgR-positive tumor cells did not achieve pCR. No significant correlation was observed between pCR and the menopausal status, tumor size, grade and Ki-67 expression. In univariate analysis, pCR was associated with the ER status (p=0.001), PgR status (p=0.0001) and chemotherapy regimens (p=0.03). Multivariate analysis revealed that ER and PgR status were significant factors for pCR, and patients with ER-negative tumors were 18.6 times more likely to achieve pCR than those with greater than or equal to 30% ER-positive tumor cells (p=0.006; 95% confidence interval 2.3-149.9). We demonstrated a predictive significance of the proportion of ER-positive or PgR-positive tumor cells in the response to neoadjuvant chemotherapy for operable HER2-negative breast cancer. ER-negativity (<1%) was a significant predictive factor for achieving pCR in multivariate analysis. Conversely, patients with more than 30% ER-positive tumor cells or more than 1% PgR-positive tumor cells may not achieve pCR.
雌激素受体（ER）和孕激素受体（PgR）状态是可手术乳腺癌新辅助化疗临床和病理反应的预测因素。然而，ER阳性或PgR阳性肿瘤细胞的比例如何影响新辅助化疗的反应仍不清楚。我们研究了ER阳性或PgR阳性肿瘤细胞比例与可手术的人表皮生长因子受体2（HER2）阴性乳腺癌新辅助化疗临床和病理反应之间的相关性。2002年4月至2010年10月，103例患者在我院接受了含表柔比星和紫杉烷的新辅助化疗。86例（83%）患者观察到临床反应，16例（16%）患者观察到病理完全缓解（pCR）。46例ER阴性肿瘤患者中有14例（30%）达到pCR，57例PgR阴性肿瘤患者中有15例（26%）达到pCR。ER阳性肿瘤细胞超过30%或PgR阳性肿瘤细胞超过1%的患者未达到pCR。pCR与绝经状态、肿瘤大小、分级及Ki-67表达之间未观察到显著相关性。单因素分析显示，pCR与ER状态（p=0.001）、PgR状态（p=0.0001）及化疗方案（p=0.03）相关。多因素分析显示，ER和PgR状态是pCR的显著因素，ER阴性肿瘤患者达到pCR的可能性是ER阳性肿瘤细胞大于或等于30%患者的18.6倍（p=0.006；95%置信区间2.3-149.9）。我们证明了ER阳性或PgR阳性肿瘤细胞比例在可手术HER2阴性乳腺癌新辅助化疗反应中的预测意义。在多因素分析中，ER阴性（<1%）是达到pCR的显著预测因素。相反，ER阳性肿瘤细胞超过30%或PgR阳性肿瘤细胞超过1%的患者可能无法达到pCR。
