The Study Of Change And Clinical Significance Of Ki67 And ALDH1 Before And After Neoadjuvant Chemotherapy In Breast Cancer

Objective:Breast cancer is a highly heterogeneous tumor at the molecular level and the response to chemotherapy between breast cancer patients is large differences. The aim of this study was to investigate the efficacy of NAC for breast cancer on Ki67 and aldehyde dehydrogenase 1 (ALDH1), and to explore the value of Ki67 and ALDH1 predict response of NAC in breast cancer, and further analysis risk factor of outcome after NAC for breast cancer.Methods:105 Female patients with breast cancer were selected from the department of breast in Cancer Institute and Hospital of Tianjin Medical University, from 2007 June to 2009 September. Expression of Ki67 and ALDH1 before and after NAC were measured by immunohistochemisthy(IHC).Their clinical and pathological material were retrospectively analyzed.Results:1.105 female patients were treated 2-4 cycles NAC. The complete response (CR) rate was18.1%(19/105), the partial response 56.2%(59/105),the stable disease (SD) rate was 24.8%(26/105), and the progress disease (PD) was 0.9%(1/105).The clinical response rate was (cCR+cPR) 74.3%.The result of pathology assessment:high sensitivity in 18 cases (17.1%), moderately sensitive in 28 cases(26.7%), light sensitive in 30 cases(28.6%), no sensitive in 29 cases(27.6%). The overall pathological response was 72.4%.2.In total, positive expressed Ki67 were 65.7%(69/105)tumors before chemotherapy, whereas 36.2%(38/105) after chemotherapy. The positive expression of Ki67 before NAC was significant higher than that after NAC (P<0.05). The reduction of Ki67 in efficacy group was significantly higher than inefficacy group(P<0.05).The response to NAC in Ki67 positive expression group was significantly higher than that in negative group(P<0.05).3. ALDH1 positive expression rate was 25.7%(27/105) before chemotherapy and 39.0%(41/105) after chemotherapy. The positive expression of ALDH1 before NAC was significant lower than that after NAC (P<0.05).4.The efficacy of chemotherapy in breast cancer among Ki67+/ALDH1-Ki67+/ALDH1+,Ki67-/ALDH1- and Ki67-/ALDH1+phenotype was significant (P<0.05), Ki67+/ALDH1- and Ki67+/ALDH1+phenotype were higher than Ki67-/ALDH1- and Ki67-/ALDH1+phenotype.5. The high TNM stage and the number of positive node might be the meaningful parameters influencing the outcome.Conclusion:1. Chemotherapy can change the expression of Ki67 in breast tumor. Chemotherapy can reduced the expression of Ki67, inhibit the growth of breast tumor, so we can monitor response to threatment by detecting Ki67.Ki67 can be marker for predicting the effect of NAC.2. Chemotherapy can change the expression of ALDH1 in breast tumor.3. Combined detection of the expression of Ki67 and ALDH1 can predict the effects of chemotherapy.4. High clinical stage and lymph node metastasis were related factors to outcome after NAC.