乳腺癌新辅助化疗前后对ER PR Her-2及Ki-67表达影响及预后中的意义
发布时间：2018-08-13 17:15
【摘要】：目的1通过对乳腺癌患者新辅助化疗前后ER、PR、Her-2和Ki-67的表达变化情况的数据统计分析,从而分析新辅助化疗对乳腺癌分子表达物的影响;2通过数据整理,分析ER、PR、Her-2和Ki-67在新辅助化疗前后变化情况,为乳腺癌患者个体化治疗提供依据,进一步推测此类变化对患者预后的意义及研究价值。方法实验样本选用华北理工大学附属医院及唐山市人民医院2010年1月至2014年1月收治乳腺癌患者62例,均为单侧乳房患病的女性患者,无患侧乳腺手术史及辅助化疗或放疗史,年龄31-73岁之间,中位年龄53岁。根据《NCCN指南》中标准新辅助化疗方案,均采用TAC新辅助化疗方案(多西他赛75mg/m2,多柔比星50 mg/m2,环磷酰胺500 mg/m2),以3周(即21天)为一个化疗周期,共行3个周期的术前化疗治疗。采用免疫组化S-P法检测样本中乳腺癌患者在新辅助化疗前后ER、PR、Her-2及Ki-67的表达情况,整理数据使用统计学软件SPSS19.0分析ER、PR、Her-2及Ki-67的表达在新辅助化疗前后的改变情况,分析新辅助化疗对乳腺癌分子表达物的影响以及预测此类变化对患者预后的意义和研究价值。结果新辅助化疗前后部分乳腺癌患者肿瘤分子表达物发生了变化。新辅助化疗前ER(—)患者为35例,ER(+)患者27例,化疗后ER(—)患者33例,ER(+)患者29例,化疗前后ER由阴性转为阳性者5例,由阳性转为阴性者3例,改变率为12.9%,比较新辅助化疗前后数据,差异不具有统计学意义(P0.05)。新辅助化疗前PR(—)患者为37例,PR(+)患者25例,化疗后PR(—)患者34例,PR(+)患者28例,化疗前后PR由阴性转为阳性者5例,由阳性转为阴性者2例,改变率为11.3%,比较新辅助化疗前后数据,差异不具有统计学意义(P0.05)。新辅助化疗前Her-2(低表达)患者为23例,Her-2(过表达)患者39例,化疗后Her-2(低表达)患者16例,Her-2(过表达)患者46例,化疗前后Her-2由低表达转为过表达者8例,由过表达转为低表达者1例,改变率为14.5%,比较新辅助化疗前后数据,差异不具有统计学意义(P0.05)。新辅助化疗前Ki-67(—)患者为38例,Ki-67(+)患者24例,化疗后Ki-67(—)患者49例,Ki-67(+)患者13例,化疗前后Ki-67由阴性转为阳性者2例,由阳性转为阴性者13例,改变率为24.2%,比较新辅助化疗前后数据,差异具有统计学意义(P0.05)。新辅助化疗可改变部分乳腺癌患者的Ki-67分子表达,但对于ER、PR及Her-2的分子表达无明显影响。结论1本研究结果表明:Ki-67在NAC后阳性表达率降低(P0.05),而ER、PR、Her-2的表达状态在NAC前后未发生明显变化。2 Ki-67在NAC前后表达水平的改变,对于患者预后的评估具有临床研究价值。
[Abstract]:Objective 1 to analyze the effect of neoadjuvant chemotherapy on molecular expression of breast cancer by statistical analysis of the changes of ERR PRN Her-2 and Ki-67 expression in breast cancer patients before and after neoadjuvant chemotherapy. To analyze the changes of Her-2 and Ki-67 in patients with breast cancer before and after neoadjuvant chemotherapy, to provide evidence for individualized treatment of breast cancer, and to further speculate the significance and value of these changes in the prognosis of patients with breast cancer. Methods Sixty-two breast cancer patients were selected from affiliated Hospital of North China University of Technology and people's Hospital of Tangshan City from January 2010 to January 2014. All of them were female patients with unilateral breast disease and had no history of breast surgery or adjuvant chemotherapy or radiotherapy. The age ranged from 31 to 73 years, with a median age of 53 years. According to the standard neoadjuvant chemotherapy regimen in NCCN guidelines, TAC neo-adjuvant chemotherapy regimen (docetaxel 75 mg / m2, doxorubicin 50 mg / m2, cyclophosphamide 500 mg/m2) was used for three cycles of preoperative chemotherapy. Immunohistochemical S-P method was used to detect the expression of ERP Her-2 and Ki-67 in breast cancer patients before and after neoadjuvant chemotherapy. Statistical software SPSS19.0 was used to analyze the changes of ERP Her-2 and Ki-67 expression before and after neoadjuvant chemotherapy. To analyze the effect of neoadjuvant chemotherapy on the molecular expression of breast cancer and its significance in predicting the prognosis of breast cancer. Results before and after neoadjuvant chemotherapy, the tumor molecular expression of some breast cancer patients changed. There were 35 cases of ER (-) before neoadjuvant chemotherapy, 27 cases of ER (-) and 29 cases of ER (-) after chemotherapy. Before and after chemotherapy, ER (-) changed from negative to positive in 5 cases, and from positive to negative in 3 cases. The change rate was 12.9, compared with the data before and after neoadjuvant chemotherapy, the difference was not statistically significant (P0.05). There were 37 cases of PR (-) before neoadjuvant chemotherapy, 25 cases of PR (-), 28 cases of PR (-) after chemotherapy, 5 cases of PR changed from negative to positive before and after chemotherapy, and 2 cases changed from positive to negative. The change rate was 11. 3%, the difference was not statistically significant (P0.05) compared with the data before and after neoadjuvant chemotherapy. Before neoadjuvant chemotherapy, there were 23 cases of Her-2 (overexpression) in 39 cases, 16 cases of Her-2 (low expression) in 16 cases (overexpression) before and after chemotherapy, and 8 cases of Her-2 changed from low expression to overexpression before and after chemotherapy. The rate of change from over-expression to low-expression was 14.5. the difference was not statistically significant before and after neoadjuvant chemotherapy (P0.05). There were 38 patients with Ki-67 (-) before neoadjuvant chemotherapy, 24 patients with Ki-67 and 13 patients with Ki-67 (-) after chemotherapy. Before and after chemotherapy, Ki-67 changed from negative to positive in 2 cases, and from positive to negative in 13 cases. The change rate was 24. 2%, compared with the data before and after neoadjuvant chemotherapy, the difference was statistically significant (P0.05). Neoadjuvant chemotherapy could change the expression of Ki-67 molecules in some breast cancer patients, but had no significant effect on the expression of ERP PR and Her-2 molecules. Conclusion 1 the results of this study showed that the positive expression rate of Ki-67 decreased after NAC (P0.05), but the expression of ERG PR-Her-2 did not change significantly before and after NAC. The expression level of .2 Ki-67 before and after NAC had a clinical value in evaluating the prognosis of patients.
【学位授予单位】：华北理工大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R737.9
，
本文编号：2181655
[Abstract]:Objective 1 to analyze the effect of neoadjuvant chemotherapy on molecular expression of breast cancer by statistical analysis of the changes of ERR PRN Her-2 and Ki-67 expression in breast cancer patients before and after neoadjuvant chemotherapy. To analyze the changes of Her-2 and Ki-67 in patients with breast cancer before and after neoadjuvant chemotherapy, to provide evidence for individualized treatment of breast cancer, and to further speculate the significance and value of these changes in the prognosis of patients with breast cancer. Methods Sixty-two breast cancer patients were selected from affiliated Hospital of North China University of Technology and people's Hospital of Tangshan City from January 2010 to January 2014. All of them were female patients with unilateral breast disease and had no history of breast surgery or adjuvant chemotherapy or radiotherapy. The age ranged from 31 to 73 years, with a median age of 53 years. According to the standard neoadjuvant chemotherapy regimen in NCCN guidelines, TAC neo-adjuvant chemotherapy regimen (docetaxel 75 mg / m2, doxorubicin 50 mg / m2, cyclophosphamide 500 mg/m2) was used for three cycles of preoperative chemotherapy. Immunohistochemical S-P method was used to detect the expression of ERP Her-2 and Ki-67 in breast cancer patients before and after neoadjuvant chemotherapy. Statistical software SPSS19.0 was used to analyze the changes of ERP Her-2 and Ki-67 expression before and after neoadjuvant chemotherapy. To analyze the effect of neoadjuvant chemotherapy on the molecular expression of breast cancer and its significance in predicting the prognosis of breast cancer. Results before and after neoadjuvant chemotherapy, the tumor molecular expression of some breast cancer patients changed. There were 35 cases of ER (-) before neoadjuvant chemotherapy, 27 cases of ER (-) and 29 cases of ER (-) after chemotherapy. Before and after chemotherapy, ER (-) changed from negative to positive in 5 cases, and from positive to negative in 3 cases. The change rate was 12.9, compared with the data before and after neoadjuvant chemotherapy, the difference was not statistically significant (P0.05). There were 37 cases of PR (-) before neoadjuvant chemotherapy, 25 cases of PR (-), 28 cases of PR (-) after chemotherapy, 5 cases of PR changed from negative to positive before and after chemotherapy, and 2 cases changed from positive to negative. The change rate was 11. 3%, the difference was not statistically significant (P0.05) compared with the data before and after neoadjuvant chemotherapy. Before neoadjuvant chemotherapy, there were 23 cases of Her-2 (overexpression) in 39 cases, 16 cases of Her-2 (low expression) in 16 cases (overexpression) before and after chemotherapy, and 8 cases of Her-2 changed from low expression to overexpression before and after chemotherapy. The rate of change from over-expression to low-expression was 14.5. the difference was not statistically significant before and after neoadjuvant chemotherapy (P0.05). There were 38 patients with Ki-67 (-) before neoadjuvant chemotherapy, 24 patients with Ki-67 and 13 patients with Ki-67 (-) after chemotherapy. Before and after chemotherapy, Ki-67 changed from negative to positive in 2 cases, and from positive to negative in 13 cases. The change rate was 24. 2%, compared with the data before and after neoadjuvant chemotherapy, the difference was statistically significant (P0.05). Neoadjuvant chemotherapy could change the expression of Ki-67 molecules in some breast cancer patients, but had no significant effect on the expression of ERP PR and Her-2 molecules. Conclusion 1 the results of this study showed that the positive expression rate of Ki-67 decreased after NAC (P0.05), but the expression of ERG PR-Her-2 did not change significantly before and after NAC. The expression level of .2 Ki-67 before and after NAC had a clinical value in evaluating the prognosis of patients.
【学位授予单位】：华北理工大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R737.9
，
本文编号：2181655
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