Oncology Unit, Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Via Giustiniano, Aprilia, Italy.
Division of Medical Oncology A, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy.
Cancer Chemother Pharmacol. 2020 Jan;85(1):105-111. doi: 10.1007/s00280-019-03981-5. Epub 2019 Nov 21.
Many studies have indicated that the response to therapy and the prognostic impact of a pathologic complete response after neoadjuvant treatment differ among breast cancer subtypes.
The aim of our study is to evaluate the effect of this treatment on the expression of estrogen and progesterone receptors, human epidermal growth hormone receptor 2 and Ki67 in breast cancer. We identified 125 patients.
The estrogen receptor modified its expression from positive to negative in 8% patients and from negative to positive in 22%; progesterone in 21% and in 37% cases. Median Ki-67 value was 20.9% at biopsy and 18% after, HER-2 status did not show a remarkable change before or after neoadjuvant chemotherapy (NACT). We have identified a significant reduction in Ki-67 expression levels after chemotherapy in patients with a pathologic response. Detection of pretreatment Ki-67 could identify patients most likely to benefit from NACT.
NACT can change the status of ER, PgR, and Ki-67 expression in patients with breast adenocarcinoma, but it did not exert a significant effect on HER-2 status; HER-2 amplification appears to be more stable. We have identified a prognostic role for a decreased expression of PgR and Ki-67 after preoperative chemotherapy in breast cancer patients.
许多研究表明，新辅助治疗后病理完全缓解的治疗反应和预后影响在乳腺癌亚型之间存在差异。
我们的研究旨在评估这种治疗方法对乳腺癌中雌激素和孕激素受体、人表皮生长因子受体 2 和 Ki67 的表达的影响。我们确定了 125 名患者。
8%的患者雌激素受体的表达由阳性转为阴性，22%的患者由阴性转为阳性；孕激素受体在 21%和 37%的病例中发生变化。Ki-67 中位数在活检时为 20.9%，在新辅助化疗（NACT）后为 18%；HER-2 状态在 NACT 前后没有明显变化。我们发现，病理反应患者的 Ki-67 表达水平在化疗后显著降低。检测治疗前 Ki-67 可以识别最有可能从 NACT 中获益的患者。
NACT 可以改变乳腺癌患者中 ER、PgR 和 Ki-67 的表达状态，但对 HER-2 状态没有显著影响；HER-2 扩增似乎更稳定。我们发现，乳腺癌患者术前化疗后 PgR 和 Ki-67 表达降低与预后相关。
