Zhou Yi-jun, Ying Min, He Ying-jian, Liu Yi-qiang, Fan Zhao-qing, Fan Tie, Li Jin-feng, Wang Tian-feng, Xie Yun-tao, Lu Ai-ping, Ouyang Tao
Breast Cancer Prevention & Treatment Center, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital & Institute, Beijing 100142, China.
Zhonghua Yi Xue Za Zhi. 2013 Jun 11;93(22):1711-5.
To explore the correlations between molecular subtypes and responses to neoadjuvant chemotherapy in primary breast cancer patients.
The core-needle biopsy specimens were collected from 563 patients undergoing 4-8 cycles of neoadjuvant chemotherapy between January 2001 to January 2009. And immunohistochemical assays were employed to detect the levels of estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2 (HER2) and Ki-67 proliferation index simultaneously. Molecular subtypes were divided on the basis of immunohistochemical results. And the associations between molecular subtypes and responses to neoadjuvant chemotherapy were analyzed in 563 patients.
The pathological complete response (pCR) rates of patients with hormone receptor-negative/HER2-negative subtype (HR-/HER2-) , HER2-positive subtype (HER2+) and hormone receptor-positive/HER2-negative subtype (HR+/HER2-) were 38.9%, 17.9% and 8.3% respectively. In univariate analysis, there were significant differences in pCR rates among the groups (P < 0.001) . In multivariate analysis, the patients with HER2+ subtype had a significantly higher pCR rate than those with HR+/HER2- subtype (OR = 0.344, P = 0.002) . Whereas the patients with HER2+ subtype had a significantly lower pCR rate than those with HR-/HER2- subtype (OR = 2.453, P = 0.007) . Among HR+/HER2-subtypes, a higher pCR rate was observed in the group of high expression level of Ki-67 proliferation index (Ki-67 ≥ 20%) (P = 0.004) . But no significant differences existed in pCR rates between the group of high expression level of hormone receptor and the group of non-high expression level (P = 0.256) .
There were correlations between molecular subtypes and responses to neoadjuvant chemotherapy in primary breast cancer patients. Patients of HER2+and HR-/HER2- subtype are more likely to respond to neoadjuvant chemotherapy. Among HR+/HER2-subtypes, those with a high level of Ki-67 proliferation index tend to benefit from neoadjuvant chemotherapy.
探讨原发性乳腺癌患者分子亚型与新辅助化疗反应之间的相关性。
收集2001年1月至2009年1月期间接受4 - 8周期新辅助化疗的563例患者的粗针活检标本。采用免疫组化法同时检测雌激素受体（ER）、孕激素受体（PR）、人表皮生长因子受体2（HER2）水平及Ki-67增殖指数。根据免疫组化结果划分分子亚型。分析563例患者分子亚型与新辅助化疗反应之间的关联。
激素受体阴性/HER2阴性亚型（HR-/HER2-）、HER2阳性亚型（HER2+）和激素受体阳性/HER2阴性亚型（HR+/HER2-）患者的病理完全缓解（pCR）率分别为38.9%、17.9%和8.3%。单因素分析中，各组间pCR率有显著差异（P < 0.001）。多因素分析中，HER2+亚型患者的pCR率显著高于HR+/HER2-亚型患者（OR = 0.344，P = 0.002）。而HER2+亚型患者的pCR率显著低于HR-/HER2-亚型患者（OR = 2.453，P = 0.007）。在HR+/HER2-亚型中，Ki-67增殖指数高表达组（Ki-67≥20%）的pCR率较高（P = 0.004）。但激素受体高表达组与非高表达组之间的pCR率无显著差异（P = 0.256）。
原发性乳腺癌患者分子亚型与新辅助化疗反应之间存在相关性。HER2+和HR-/HER2-亚型患者更可能对新辅助化疗有反应。在HR+/HER2-亚型中，Ki-67增殖指数高的患者倾向于从新辅助化疗中获益。
