| Introduction：Breast cancer is currently the world against one of the commonmalignant tumor in women’s health, although its incidence rate is rising year by yearand remains high, but the mortality rate is on the decline, this is mainly due to thesystem of diagnosis and treatment of breast cancer and standardization of treatmentstandards greatly improved. Breast cancer is a systemic disease, chemotherapy plays animportant role in the treatment, neoadjuvant chemotherapy plays an important role inthe effectiveness and predict the sensitivity of chemotherapy for breast cancer, so thenew adjuvant chemotherapy is the key point of study of breast cancer, neoadjuvantchemotherapy and the advantages are mainly embodied in their the curative effect ofchemotherapy. Factors which affect the efficacy of neoadjuvant chemotherapy is a focusof scholars, the research of tumor biomarkers is hot, aimed at finding effectiveevaluation of neoadjuvant chemotherapy and judging prognosis index. Ki67is a closelyrelated to cell proliferation nuclear antigen, is currently the most widely used byscholars for evaluating the ability of tumor cell proliferation and tumor markers.Through this experiment to detect tumors before and after neoadjuvant chemotherapy inbreast cancer tissue from different levels of expression of Ki67and its change in theneoadjuvant chemotherapy in the situation, associated with the Neo-Confucianismeffect, comparative analysis of Ki67in the correlation effect between different andpathologic expressions before and after neoadjuvant chemotherapy, and to evaluate thevalue of expression of Ki67on prediction of chemosensitivity, and prediction on thenew adjuvant chemotherapy.Ki67is a closely related to cell proliferation nuclear antigen, is used to evaluatecell proliferation ability factor of the most widely. Through this experiment,neoadjuvant chemotherapy before and after expression and variation of Ki67in tumortissue of breast cancer specimens, associated with the pathological results, comparative analysis of Ki67in the relationship between the expression and pathological efficacy ofneoadjuvant chemotherapy, and to investigate the expression of Ki67to predictchemosensitivity of value, and its effect on neoadjuvant chemotherapy.Objective：1. Observation of menstruation, different in patients with breast cancerafter neoadjuvant chemotherapy and the size of primary tumor staging, lymph nodemetastasis, histological type and estrogen receptor expression and different pathologicalrelationship between efficiency and its clinical significance.2. Analysis of the expression and change of Ki67before and after neoadjuvantchemotherapy, and to observe the effect of neoadjuvant chemotherapy on the expressionof Ki67in breast cancer.3. Analysis of molecular markers in the neoadjuvant chemotherapy of Ki67expression in the effective rate in different pathological, and the correlation analysis, thecorrelation analysis between before and after neoadjuvant chemotherapy on expressionof Ki67and its change and the effect of chemotherapy on breast cancer, explore the newauxiliary chemotherapy have prediction effect of the expression of Ki67, and understandthe value of Ki67in predicting the efficacy of neoadjuvant chemotherapy in breastcancer.Methods：Collect40cases，in patients with primary breast cancer can be operationin breast surgery,at Liaoning Provincial Tumor Hospital,2011January--2012December，both for initial treatment of women. All patients were treated by the coreneedle biopsy for pathological diagnosis, preoperative neoadjuvant chemotherapy forthree cycles and after two weeks of rest, take the breast cancer radical operation therapy,postoperative again on breast cancer resection of pathological examination. With theexpression of before and after neoadjuvant chemotherapy in breast cancer, Ki67andother indicators was detected by staining in immunohistochemistry SP in40patients,pathological Miler and Payne on the efficacy of neoadjuvant chemotherapy (MP)treatment response evaluation method to evaluate the pathological therapeutic responselevel of breast cancer after operation; according to the percentage of Ki67positive cellsdivided into the low expression group and high expression group, and Ki67weredivided into mild group decreased and decreased significantly in decline afterneoadjuvant chemotherapy in breast cancer, the relationship between the statisticalanalysis of neoadjuvant chemotherapy with Ki67expression between states. Count datausing chi-square test facility.Results：1.Neoadjuvant chemotherapy group and pathology pathological effective invalid menstruation, patients with estrogen receptor (ER) status in the group, thestaging of breast cancer, lymph node were not statistically significant difference ofmetastasis, histological type (P>0.05), that this group of patients, pathological remissionrate and menstrual status, breast cancer staging, lymph node metastasis, histologicaltype, independent of estrogen receptor status.2.After neoadjuvant chemotherapy in the positive rate of Ki67was significantlydecreased compared with before treatment, the difference was statistically significant(p<0.05).3.And in the pathology of efficiency, high expression of Ki67in neoadjuvantchemotherapy group efficiency (52.5%) was higher than that of the low expression ofgroup Ki67(22.5%), the difference was statistically significant (x2value=5.76,0.01<P<0.05); Ki67expression was significantly decreased in group of effective ratewas significantly higher than that of Ki67mild pathology under descending, thedifference was statistically significant (x2value=13.8, P<0.005).Discussion：The occurrence and the development of tumor cell degeneration andcell proliferation and apoptosis in the balance between having close relationship, bothinvolved in the maintenance of tissue cell stability, this balance in chemotherapy persist.Due to the low expression of Ki67before chemotherapy, tumor cell proliferation ratealso increased. Ki67is important for inhibiting apoptosis gene expression, the extensionof tumor cell life, make the tumor with a slower rate of growth. But after chemotherapyincreases the expression of Ki67, AI also has a corresponding reduction, the decrease ofKi67value is also reflected from the other side of the tumor cell proliferation ratereduce, also shows that the equilibrium relationship.The results of this study, before treatment Ki67has a high expression of tumorresponse to chemotherapy. After chemotherapy in tumor tissue Ki67expression wassignificantly decreased, and increased expression of Ki67, with the previously reportedresults. Cytotoxic drug to active proliferation of cells more efficiently, and slow theproliferation of cells in the three cycle of chemotherapy during selective survival. AIdecreased and Bcl-2increased to reflect such cells may differentiate better or dormantperiod; the phenomenon of increased Ki67expression in another interpretation isbecause the tumor blood vessels less, residual tissue around in hypoxia, the expressioConclusion：1. Neoadjuvant chemotherapy can effectively inhibit the growth ofcancer cells speed.2. Ki67is highly expressed in breast cancer patients with neoadjuvant chemotherapy.3. Ki67can be used as the sensitivity of neoadjuvant chemotherapy for breastcancer index prediction.4. Expression of neoadjuvant chemotherapy before and after the decline in Ki67levels can be used as the index of evaluating chemotherapy. |
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