Expression Of ER,PR,Her-2,ki-67 In Primary Breast Cancer And The Simultaneous Ipsilateral Axillary Lymph Node Metastasis

BackgroundThe expression levels of hormone receptors and HER-2 and ki-67 in breast cancer lesions are the guiding indexes for breast cancer typing and systemic treatment.In the past,we thought that the recurrence/metastasis breast cancer had the same molecular classification as the primary tumor.However,the immunohistochemical evaluation of the metastatic/recurrent lesions revealed that there was a difference between the primary lesion and the recurrence/metastasis lesion.Currently for patients with recurrence/metastasis breast cancer using immunohistochemical evaluation again in recurrence/metastasis lesions is more common practice.And is it needed for patients with the simultaneous ipsilateral axillary lymph node metastases to carry out separately immunohistochemical evaluation is currently no consensus.MethodThis research collected clinical and pathological data of pathological diagnosed female breast cancer patients with ipsilateral axillary lymph node metastasis without other metastasis from January 1,2015 to February 28,2010 in the Second Affiliated Hospital of Zhejiang University.By comparing the results of immunohistochemistry of ER,PR,Her-2 and ki-67 in the primary tumor in breast and the simultaneous ipsilateral axillary lymph node metastasis,the difference and consistency are statistically analyzed.All results use SPSS Statistics 19.0 software to analyze,regarding P<0.05 as statistically significant.ResultsIn the 95 patients,ER in the primary tumor and the ipsilateral axillary lymph node metastasis in the same period showed a high degree of consistency,that all patients with ER expression in the primary and axillary lymph nodes consistent.The rate of PR turn negative from primary tumor to axillary lymph node metastasis was 12.0%,the rate of PR turn positive was 11.5%,and the total change rate was 12.6%.In the 75 patients,the rate of Her-2 turn negative from primary tumor to axillary lymph node metastasis rate was 4.0%,the rate of Her-2 turn positive was4.0%,and the total change rate was4.0%.In the 93 cases,the rate of ki-67 turn negative from the primary lesion to axillary lymph node metastasis wasl9.7%,the rate of ki-67 turn positive was 15.6%,the total rate change rate was 18.3%.There was no significant difference in of the above expression change(P>0.05).ER,PR,Her-2 and ki-67 were analyzed by age,tumor size and number of axillary lymph node metastasis,and there was no significant difference(P>0.05)respectively.Conclusion1.It presented high coincidence in the expression of ER,PR,Her-2 and ki-67 between the axillary lymph node metastasis and the primary breast cancer,but there was a certain degree of discordance,but there was no significant difference.And the number of tumors,the size of the tumor,the number of axillary lymph node metastases had no effect on the changes in these indicators.2.There are cases from negative to positive and from positive to negative in all the indexes including PR,Her-2,ki-67 separately.And such changes may be more meaningful in the clinical process for treatment planning and predicting the response.It is recommended that a comprehensive pathologic examination may execute to increase the likelihood of treatment benefit for some patients.And such changes in marker expression may have the effect of predicting the response of treatment but it still requires long-term and large sample follow-up to confirm.