目的：分析乳腺癌患者在新辅助化疗(NAC)前后的雌激素受体(ER)、孕激素受体(PR)、人类表皮生长因子受体-2(HER-2)、Ki67以及 P53的表达意义并分析各种因子与乳腺癌化疗效果的相关性。方法60例乳腺癌患者,均采用 NAC,在化疗的前后分别检测患者的 ER、PR、HER-2、Ki67、P53的表达水平,将指标表达情况与乳腺癌化疗效果进行比较,评价对化疗效果的价值。结果60例患者在 NAC 后临床完全缓解(cCR)9例,占15.0%；病理完全缓解(pCR)5例,占8.3%；部分缓解(PR)44例,占73.3%；病情稳定(SD)2例,占3.3%；无疾病进展(PD)患者。完全缓解(CR)14例,占23.3%,总有效率(RR)为96.7%(58/60)。化疗前后的 ER 阳性率分别为53.3%(32/60)、25.0%(15/60),比较差异具有统计学意义(P<0.05)；PR 化疗前后的阳性率分别为46.7%(28/60)、26.7%(16/60),比较差异具有统计学意义(P<0.05)；HER-2化疗前后的阳性率分别为25.0%(15/60)、31.7%(19/60),比较差异无统计学意义(P>0.05)；Ki67化疗前后的阳性率分别为76.7%(46/60)、31.7%(19/60),比较差异具有统计学意义(P<0.05)；P53化疗前后的阳性率分别为35.0%(21/60)、31.7%(19/60),比较差异无统计学意义(P>0.05)。结论乳腺癌患者在 NAC 的前后 HER-2与 P53的表达对于乳腺癌的化疗效果的判断的实际意义较小,而 ER 和(或) PR 阳性的癌症患者对化疗更为敏感,且 NAC 可以有效降低 Ki67的表达,从而有效预测乳腺癌化疗的效果,故而 ER、PR 及 Ki67三者可以作为乳腺癌化疗效果重要的预测指标。%Objective To analyze expression and significance of estrogen receptor(ER), progestrone receptor (PR), human epidermal growth factor receptor-2(HER-2), Ki67 and P53 in breast cancer before and after neo-adjuvant chemotherapy (NAC) and their correlation with chemotherapy effect for breast cancer. Methods A total of 60 breast cancer patients were treated with NAC. Expression levels of ER, PR, HER-2, Ki67 and P53 were detected before and after chemotherapy. Index expression were compared with chemotherapy effect of breast cancer before and after NAC, and evaluated their value to chemotherapy effect. Results There were 9 clinical complete remission (cCR) cases, accounting for 15.0%, 5 pathologic complete remission (cCR) cases, accounting for 8.3%, 44 partial remission (PR) cases, accounting for 73.3%, 2 stable disease (SD) cases, accounting for 3.3%, 0 progression disease (PD) case, with 14 CR cases, accounting for 23.3%, total remission rate (RR) as 96.7%(58/60). ER positive rate before and after chemotherapy were 53.3%(32/60), 25.0%(15/60), and difference had statistical significance (P<0.05). PR positive rate before and after chemotherapy were 46.7%(28/60), 26.7%(16/60), and difference had statistical significance (P<0.05). HER-2 positive rate before and after chemotherapy were 25.0%(15/60), 31.7%(19/60), and difference had no statistical significance (P>0.05). Ki67 positive rate before and after chemotherapy were 76.7%(46/60), 31.7%(19/60), and difference had statistical significance (P<0.05). P53 positive rate before and after chemotherapy were 35.0%(21/60), 31.7%(19/60), and difference had no statistical significance (P>0.05). Conclusion Expression of HER-2 and P53 before and after NAC have little significance to chemotherapy effect of breast cancer, but ER, PR positive cancer patients were more sensitive to chemotherapy. NAC can decrease expression of Ki67 effectively, which helps predict chemotherapy effect for breast cancer. So ER, PR and Ki67 are predict index for chemotherapy effect of breast cancer.
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