Comparative Study Of 71 Cases Of Metastatic Breast Cancer Recurrence Risk Factors Of Her-2 And Ki67

BACKGROUND AND OBJECTIVE:Breast cancer has been the most common female malignancy,whether in the developing countries or developed countries.Currently the main treatment for breast cancer is comprehensive treatment.The method of comprehensive treatment consists of surgery,chemotherapy,radiation therapy,targeted therapy of Trastuzumab and endocrine therapy.Therefore,according to the principles of treatment for breast cancer,the biomarkers play an important role in the treatment.Measuring biomarkers has become an important way to understand and evaluate the clinical outcomes of patients with chemotherapy.This study aimed to explore the relationship between Ki67 and Her-2,the relationship between Ki67 and clinicopathological features of metastatic breast cancer,the relationship between Her-2 and clinicopathological features of metastatic breast cancer,prognostic Factors of comparative studies.We are hoping to provide a reference for the development of individualized treatment of breast cancer.Method:A retrospective analysis of 71 cases of patients after radical distant metastasis.Case screening criteria:(1)the patients acceped tradical surgery for breast cancer,according to clinical guidelines:chemotherapy(anthracycline-based)+ radiotherapy;(2)ER/PR positive for at least one,\endocrine therapy;(3)pathology:invasive ductal carcinoma;(4)Her-2 expression by IHC 3+ positive.IHC detection 2+,FISH detected clearly.Not been targeted therapy Herceptin;(5)Mastectomy disease-free survival of more than six months.The 71 patients were divided into 2 groups:Ki67<20%for the low expression group,Ki67>20%for the high expression.HER-2 protein expression scores are divided into 0,1 +,2 +,and 3+.When the score is rated 3+ or 2+ but Fish tested positive,then divided into positive group,the other into negative group.SPASS application software analysis:1 The relationship between Ki67 with major clinicopathological features(Tumor size,histological grade,lymph node metastasis).The relationship between Her-2 with major clinicopathological features.2 Analysis of Ki67 expression and Her-2 receptor correlation。3 whether there are differences between rogression-free survival among patients with high expression group and low expression group。4 according to the expression of Ki67 and Her-2,the patients were divided into 4 groups:Ki67 high expression and HER2-positive group(n = 20),Ki67 high expression and HER2-negative group(n = 28),Ki67 low expression and HER2-positive group(n = 15)and Ki67 low expression and HER2-negative group(n = 8).Pairwise comparison analysis,the difference was more than four groups of progression-free survival.Result:(1)Ki67 high expression/low expression group and the pathological grade correlated,P = 0.005,more high-expression group(58.3%VS 17.4%)than the proportion in the low expression group histological grade Ⅲ level.Ki67 high expression/low expression group with lymph node metastasis,P=0.036<0.05.Higher(72.9%VS 41.7%)proportion of Ki67 high expression occurs with respect to the low expression of lymph node metastasis.Her-2 positive/negative with histological grade,tumor size,lymph node metastasis was no significant difference(P>0.05).(2)Progression-free survival of Ki67 high expression group and low expression group were significantly different.(P<0.001).Progression-free survival of Her-2 positive and negative groups was statistically different.(P = 0.032<0.05).Progression-free survival among different histological grading statistically different,P=0.012.Histological grade,Ki67,Her-2 and other factors COX regression analysis,results were as follows:Ki67,Her-2 and P values histological grade group were 0.000,0.000 and 0.039,less than 0.05,with statistical significance.Above are independent risk factors for breast cancer prognosis.Relative risk were 9.251,4.758 and 1.508.(3)Divided into four groups according by the expression of Her-2 and Ki67 comparison:Ki67 expression,progression-free survival in HER2-positive patients<Ki67 expression,progression-free survival in HER2-negative group<Ki67 low expression,HER2-positive group progression-free survival<Ki67 low expression,HER2-negative group progression-free survival.P values less than 0.05,with statistical significance.Conclusion:(1)Ki67 expression was correlated with the histological grade level,whether there is lymph node metastasis.Ki67 was not correlated with tumor size.Her-2 expression with histological grade,lymph node metastasis and tumor size is not relevant.(2)Ki67 high expression,Her-2 positive,high-grade organization is independent risk factors affect prognosis in patients with metastatic breast cancer;however,tumor size,number of lymph node metastasis was not independent risk factors.(3)breast cancer patients with high expression of Ki67 has poorer prognosis than Her-2 postive.