| Objective: ⑴To investigate the relationship between expressions of estrogen receptor(ER), progesterone receptor(PR), human epidermal growth factor receptor 2(Her-2), Ki-67 antigen(Ki-67) and neoadjuvant chemotherapy in patients with breast cancer 。 ⑵To study the effect and clinical significance of neoadjuvant chemotherapy on ER,PR,Her-2,Ki-67.Method: Selection of Qinghai university hospital in January 2013- November 2014, 60 cases accepted after coarse needle biopsy or mammotome minimally invasive rotary cutting the pathology confirmed infiltrating ductal carcinoma of the breast, While new adjuvant chemotherapy and surgery treatment of breast cancer patients, Expressions of ER,PR,Her-2,Ki-67 before and after neoadjuvant chemotherapy were detected by immunohistochemical method.Results: ⑴49 cases(81.7%) reached clinical effective, including 6 cases(10%) of clinical complete remission(c CR),43 cases(71.7%) of clinical partial response(PR). 11 cases(18.3%) were clinical invalid, all of them were stable disease(SD),none of progressive disease(PD) and pathologic complete remission(p CR).⑵The clinical efficacy rate of ER(-) patients was 90.5%, which was significantly higher than ER(+++ ~ +) patients, 55.6%, the difference was statistically significant(P<0.05). The clinical efficacy rate of ER(-) patients was 90.5%, which was significantly higher than ER(+++~ +) patients, 55.6%, the difference was statistically significant(P < 0.05). The clinical efficacy rate of patients with PR(-) and PR(+++~+) were respectively 87.9% and 70.4%, the difference was not statistically significant(P>0.05). The clinical efficacy rate of patients with Her-2 overexpression(+++) and non-overexpression(++~-) were respectively 71.4% and 73.6%, the difference was not statistically significant(P>0.05). The clinical efficacy rate of Ki-67(+++~+) patients was 90.9%, which was significantly higher than Ki-67(-) patients, 66.7%, the difference was statistically significant(P < 0.05). ⑶The positive expression rate of ER before and after neoadjuvant chemotherapy were respectively 18 cases(30%), 23 cases(38.3%), negative there were 42 cases(70%), 37 cases(61.7%). A total of 12 cases(20%) ER expression changes, including 5 cases(8.3%) were positive to negative, there are 7 cases(11.7 %) negative into a positive. NAC PR expression positive respectively before and after 27 cases(45%), 29 cases(48.3%), negative respectively with 33 cases(55%), 31 cases(51.7%). A total of 7 cases(11.7%) PR expression changes, including 3 cases(5%) were positive to negative, there are 4 cases(6.67%), negative into a positive. NAC her- 2 express positive respectively before and after 7 cases(11, 7 %), 8 cases(13.3%), negative there were 53 cases(88.3%), 52 cases(86.7 %). Including 1 cases(1.7)by the non-overexpression to over-expression.This study compared the neoadjuvant chemotherapy before and after the expression of ER,PR and Her-2 found no significant difference(P > 0.05).Conclusions: 1, The new paclitaxel combined anthracycline-based adjuvant chemotherapy scheme obtained satisfactory curative effect of breast invasive ductal carcinoma the clinical efficiency of 80.0%. 2, Neoadjuvant chemotherapy in patients with breast cancer before ER express negative prompt its curative effect is better, and the expression of PR status has nothing to do with the curative effect of neoadjuvant chemotherapy. Neoadjuvant chemotherapy have no obvious effect on the expression of ER, PR, but the new adjuvant chemotherapy can make part of the quantitative change ER, PR expression in patients with breast cancer.3, neoadjuvant chemotherapy in patients with breast cancer before Her-2 expression status has nothing to do with the efficacy of chemotherapy. Neoadjuvant chemotherapy does not change Her-2 expression of the state. 4,Neoadjuvant chemotherapy can significantly decrease Ki-67 expression.Ki67 can predict theeffect of neoadjuvant chemotherapy for breast cancer. |
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