Expression Changes And Predictive Values Of ER, PR, Ki-67and HER-2in Neoadjuvant Chemotherapy Of Breast Cancer

Objective (1) By detecting and camparing the expressions of ER, PR, Ki-67and HER-2in breast cancer before and after neoadjuvant chemotherapy (NAC), analysethe impact of NAC on their expressions.(2) By detecting the sensitivity of ER, PR,Ki-67and HER-2with NAC, provide a reference for individualized treatment.Methods Collect breast cancer patients who were treated in Breast Surgerydepartment of Dalian Central Hospital from June2011to January2013.45cases ofbreast ductal invasive carcinoma were diagnosed by the core needle or Mammotomebiopsy and pathological classification.All patients were female, unilateral lesions, aged27to70years old, with a median age of52years old. Preoperative neoadjuvantchemotherapy was with unified FEC-T program:5-FU500mg/m2IV d1, epirubicin100mg/m2IV per day, cyclophosphamide600mg/m2IV per day,21days were a cycle, and3cycles were a total. After the end of the FEC program, continuously applied paclitaxel(taxol)175mg/m2IV each3hours;21days were a cycle and3cycles were a total. Theexpression of ER, PR, ki-67and HER-2were detected by immunohistochemical methodbefore and after NAC. By Statistical methods, analyse the impact of ER, PR, Ki-67andHER-2expression and predictive values with NAC.Results (1)45patients were treated with neoadjuvant chemotherapy(FEC-T), theoverall response rate (RR) was77.8%(35/45).8cases (17.8%) with completeremission(CR), among them5cases (11.1%) with pathological completeremission(pCR),3cases (6.7%) with clinical complete remission(cCR).27cases(60.0%) with clinical partial remission (PR). All clinical remission patients underwent apredetermined NAC cycles. The other10cases (22.2%) with stable disease (SD),surgery was taken after two cycles of FEC, no progression disease (PD) cases appeared.(2) During the NAC, the NAC effective rate of ER(-) patients was90.3%(28/31), ER (+)patients was50.0%(7/14), the difference between the two groups was statisticallysignificant (p<0.05). NAC effective rate of PR (-) patients was84.0%(21/25), PR (+) patients was70.0%(14/20), no statistically significant between the two groups (p>0.05). NAC effective rate in ki-67(-) patients was61.9%(13/21), ki-67(+) patients was91.7%(22/24), the difference between the two groups was statistically significant (p<0.05). The NAC effective rate in HER-2non-overexpression group was84.2%(16/19),73.1%(19/26) in the overexpressed group, the clinical efficiency of non-overexpressiongroup is slightly higher than overexpression group, but the difference was notstatistically significant in two groups(p>0.05). Therefore, ER, ki-67can be used as asensitive factor for NAC program in breast cancer.(3) The expression of ER before andafter NAC was partly changed. The positive expression of ER was11cases before theNAC, and16cases after the NAC. The negative expression of ER was29cases beforethe NAC, and24cases after the NAC. ER expression changed in11cases(27.5%),negative shift to positive in8cases, positive shift to negative in3cases, the expressionbefore and after NAC was not statistically significant (P>0.05). Positive expression ofPR was17cases before the NAC. After the NAC, PR positive expression was19cases.Negative expression of PR was23cases before the NAC. After the NAC, PR negativeexpression was21cases. PR expression changed in6cases(15.0%), negative shift topositive in4cases, positive shift to negative in2cases, the difference was notstatistically significant (P>0.05). Ki-67positive expression was22cases before NAC;after NAC, the expression of Ki-67positive in12cases. Ki-67negative expression was18cases before NAC; after NAC, the expression of Ki-67positive in28cases. Ki-67expression changed in18cases(45.0%), negative shift to positive in4cases, positiveshift to negative in14cases, the difference was statistically significant (P<0.05). HER-2overexpression was23cases before NAC. After NAC, HER-2overexpression was25cases. HER-2non-overexpression was17cases before NAC. After NAC, HER-2non-overexpression was15cases. HER-2expression changed in10cases(25.0%),negative shift to positive in6cases, positive shift to negative in4cases, the differencewas not statistically significant (P>0.05). NAC could partly change the expression ofKi-67, but the ER,PR and HER-2expression was not influenced by the NAC.Conclusions FEC-T program for the efficacy of breast cancer patients iscertainly. The expression of ER and Ki-67before NAC can predict the efficacy of NAC.Positive rate of Ki-67was reduced after NAC. NAC could change the expression levelof Ki-67, and provide a reference for tumor individualized treatments.