Research On The Prediction Of Neoadjuvant Chemotherapy For Breast Cancer With ER,PR,HER-2,Ki67 And Molecular Subtype

【Objective】To research the predictive role of ER、PgR、HER-2、Ki67 and molecular subtypes of breast cancer on neoadjuvant chemotherapy(NAC).Screening out the relevant predictors,and provide some reference for the development of individualized treatment plan for breast cancer patients.【Methods】A total of 87 patients admitted to Fujian Provincial Hospital from February 2013 to September 2016 were enrolled in this study.The patients were diagnosed with invasive breast cancer and treated with NAC.The basic information,hollow needle puncture pathology,neoadjuvant Chemotherapy analysis,postoperative pathological results and immunohistochemical results were analyzed retrospectively.SPSS 22.0 statistical software was used to analyze the data collected from this study.The single factor analysis was analyzed by chi-square test,and multivariate analysis was performed using Logistic binary regression model.To investigate the correlation between different molecular subtypes and the biomarkers of ER,PgR,HER-2 and Ki67 in different expression states and the NAC efficacy of breast cancer,in order to select the predictive factor of NAC in breast cancer.【Results】1.Different molecular subtypes of breast cancer in the clinical efficiency(CR + PR)showed significant differences,P <0.05.The clinical effective rate of Triple-negative subtype was 68.8%,HER-2 positive subtype was 62.5%,Luminal B subtype was 53.3%,and Luminal A subtype was 24.0%.There was also a difference in the clinical efficacy of non-Luminal A subtype and Luminal A subtype: the clinical efficacy of the former was better than the latter.However,in the comparison of pCR rates only Triple-negative subtype and Luminal A subtype were significantly different: the pCR rate of the Triple-negative subtype(25%)was higher than that of the Luminal A subtype(4%),P <0.05.The clinical efficacy of breast cancer with different expression of ER,HER-2 and Ki67 were showed significant differences: In clinical efficiency,ER negative> ER positive,HER-2 positive> HER-2 negative,and Ki67 high expression> Ki67 low expression,P were 0.012,0.000,0.010,respectively;but it did not show significant difference in pCR rate.Other indicators included age,menopausal status,tumor size,lymph node status,clinical stage,the regimen of NAC and the number of chemotherapy cycles were not related to the overall clinical response rate or pCR rate,P>0.05.2.In this study,the high expression of Ki67 was a clinically effective independent predictor of breast cancer after NAC,P <0.05.The clinical efficacy of breast cancer with high expression of Ki67 was 3.083 times of that with low expression of Ki67.But ER,PgR,HER-2 and Ki67 were not confirmed as independent predictors of pCR rates.【Conclusion】1.The clinical efficacy of different molecular subtypes of breast cancer was different.The clinical efficacy of non-Luminal A subtype breast cancer was superior to that of Luminal A subtype.2.The pCR rate of Triple-negative subtype breast cancer was better than that of Luminal A subtype.3.The clinical efficacy of breast cancer with ER-negative or HER-2 positive or high expression of Ki67 was higher than others after NAC.4.The high expression of Ki67 was a clinically effective independent predictor of breast cancer after NAC.