Peng Jian-Heng, Zhang Xiang, Song Jun-Long, Ran Liang, Luo Rong, Li Hong-Yuan, Wang Yong-Hong
Health Management Center, The First Affiliated Hospital of Chongqing Medical University.
Department of Endocrine and Breast Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing.
Medicine (Baltimore). 2019 Jan;98(2):e13554. doi: 10.1097/MD.0000000000013554.
To analyze whether neoadjuvant chemotherapy (NAC) changes the expression rates of invasive ductal carcinoma (IDC) markers: estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2 (HER2), Ki67, and P53.This was a retrospective study of 112 IDC patients who underwent NAC (docetaxel+epirubicin/pirarubicin+cyclophosphamide) but without pathological complete response (pCR) in 2012 to 2013 at the First Affiliated Hospital of Chongqing Medical University. The IDC subtypes and tumor protein markers were analyzed by immunohistochemistry (IHC). Specific changes in tumor protein markers before/after NAC were compared.The decrease in the positive rate of Ki-67 was the most significant, from 75.9% before NAC to 41.1% after NAC (P < .001). The positive rate of HER2 decreased from 42.0% before NAC to 32.1% after NAC (P = .04). The positive rate of ER decreased from 66.1% before NAC to 56.2% after NAC (P = .04). Increased number of metastatic lymph nodes (P = .006) and body mass index (BMI) (P = .028) seemed to be related to conversion of PR (positive to negative). There was statistical association between the Ki-67 (positive to negative) with the age greater or equal to 50 (P = .015). The BMI greater or equal to 24 (P = .021), age greater or equal to 50 (P = .047), and blood type A (P = .038) were independently associated with conversion of P53 (positive to negative). The BMI greater or equal to 24 (P = .004), number of metastatic lymph nodes greater or equal to 1 (P = .029) and TNM stages I-II (P = .008) were statistically associated with change of HER2 (positive to negative).In patients without pCR, NAC leads to changes in Ki-67, HER2, and hormone receptor (HR) expression. Age, BMI, number of metastatic lymph nodes, and TNM stage are associated with some changes of markers.
分析新辅助化疗(NAC)是否会改变浸润性导管癌(IDC)标志物:雌激素受体(ER)、孕激素受体(PR)、人表皮生长因子受体2(HER2)、Ki67和P53的表达率。
这是一项对112例IDC患者的回顾性研究,这些患者于2012年至2013年在重庆医科大学附属第一医院接受了NAC(多西他赛+表柔比星/吡柔比星+环磷酰胺)治疗,但未达到病理完全缓解(pCR)。通过免疫组织化学(IHC)分析IDC亚型和肿瘤蛋白标志物。比较NAC前后肿瘤蛋白标志物的具体变化。
Ki-67阳性率下降最为显著,从NAC前的75.9%降至NAC后的41.1%(P<0.001)。HER2阳性率从NAC前的42.0%降至NAC后的32.1%(P=0.04)。ER阳性率从NAC前的66.1%降至NAC后的56.2%(P=0.04)。转移淋巴结数量增加(P=0.006)和体重指数(BMI)增加(P=0.028)似乎与PR的转变(阳性转为阴性)有关。Ki-67(阳性转为阴性)与年龄大于或等于50岁存在统计学关联(P=0.015)。BMI大于或等于24(P=0.021)、年龄大于或等于50岁(P=0.047)和A型血(P=0.038)与P53的转变(阳性转为阴性)独立相关。BMI大于或等于24(P=0.004)、转移淋巴结数量大于或等于1(P=0.029)和TNM分期I-II期(P=0.008)与HER2的变化(阳性转为阴性)存在统计学关联。
在未达到pCR的患者中,NAC导致Ki-67、HER2和激素受体(HR)表达发生变化。年龄、BMI、转移淋巴结数量和TNM分期与某些标志物的变化有关。