Zhang Hui, Zhang Xiaoyu, Jin Lijun, Wang Zunyi
Department of Thyroid and Breast III, Cangzhou Central Hospital Cangzhou, Hebei, China.
Am J Transl Res. 2022 Jul 15;14(7):4648-4656. eCollection 2022.
The purpose of this study was to evaluate the effect of neoadjuvant chemotherapy (NAC) on the responses and survival rates of patients with different molecular subtypes of breast cancer.
A retrospective analysis was conducted on 284 breast cancer patients who underwent NAC in our hospital from January 2017 to January 2019. The patients were classified into the Luminal A (n=87), Luminal B (n=78), human epidermal growth factor receptor 2 positive (HER-2, n=66), and triple-negative (TN, n=53) breast cancer subtypes. The Ki67 expressions and clinical prognoses were compared among the patients in the four subtypes.
The complete response (CR) rates were significantly higher in the HER-2 and TN patients than they were in the Luminal A and Luminal B subtype patients (P<0.05). The HER-2 and TN breast cancer patients had significantly higher response rates (RR) than the Luminal B patients (P<0.05). The Ki67 expressions decreased significantly in the patients with the Luminal B, HER-2, and TN subtypes after NAC (P<0.05), with a greater decrease in the Ki67 expressions in the HER-2 and TN subtypes than in the Luminal B subtypes (P<0.05). The Ki67 levels decreased significantly in the patients with CR or PR compared to the stable disease (SD) and progressive disease (PD) patients (P<0.05). The HER-2 patients had remarkably higher distant metastasis rates, compared to the patients with the Luminal A and B subtypes (P<0.05).
Statistical differences were found in the pathological responses and survival rates in the patients with the different molecular subtypes of breast cancer after the NAC treatment. The HER-2 or TN breast cancer patients had higher pathological response rates, which may be closely related to their decreased Ki67 expressions. Interestingly, the HER-2 breast cancer patients also showed a higher distant metastasis rate, which warrants further analysis.
本研究旨在评估新辅助化疗（NAC）对不同分子亚型乳腺癌患者反应及生存率的影响。
对2017年1月至2019年1月在我院接受NAC的284例乳腺癌患者进行回顾性分析。患者被分为Luminal A型（n = 87）、Luminal B型（n = 78）、人表皮生长因子受体2阳性（HER-2，n = 66）和三阴性（TN，n = 53）乳腺癌亚型。比较四种亚型患者的Ki67表达及临床预后。
HER-2和TN患者的完全缓解（CR）率显著高于Luminal A和Luminal B亚型患者（P<0.05）。HER-2和TN乳腺癌患者的反应率（RR）显著高于Luminal B患者（P<0.05）。NAC后，Luminal B、HER-2和TN亚型患者的Ki67表达显著降低（P<0.05），HER-2和TN亚型患者的Ki67表达下降幅度大于Luminal B亚型（P<0.05）。与疾病稳定（SD）和疾病进展（PD）患者相比，CR或PR患者的Ki67水平显著降低（P<0.05）。与Luminal A和B亚型患者相比，HER-2患者的远处转移率显著更高（P<0.05）。
NAC治疗后，不同分子亚型乳腺癌患者的病理反应和生存率存在统计学差异。HER-2或TN乳腺癌患者的病理反应率较高，这可能与其Ki67表达降低密切相关。有趣的是，HER-2乳腺癌患者的远处转移率也较高，值得进一步分析。
