The Forecast Value Of Ki-67 In Neoadjuvant Chemotherapy In Breast Cancer

Background:Breast cancer heavily does harm to lives and health of women.It keeps the first place of mortality and 25%of primary cancer is breast cancer.In China,the incidence of breast cancer is increasing year by year.The national cancer data show that in China about 248 thousand people being diagnosed as breast cancer and 37.86% of primary cancer is breast cancer.Therefore,more and more people focus on breast cancer.The study found that the occurrence,development and metastasis of breast cancer is very complex,local treatment of breast cancer is impossible.Then chemotherapy arises at the historic moment,changed the treatment of breast cancer model.With the further study of breast cancer and neoadjuvant chemotherapy,at first,neoadjuvant chemotherapy is widely used in locally advanced and inflammatory breast cancer,but now many patients can choose preoperative therapy to narrow the tumor size and reduce local metastasis and recurrence of breast cancer.But studies shows that about a quarter of the patients will produce the drug resistance during chemotherapy.For these patients,neoadjuvant chemotherapy not only bring side effects to them,also delay the treatment of their disease,and even make them lose the operative opportunity.Therefore,for clinicians,finding a biomarker to predict the effect of neoadjuvant chemotherapy is very important.The object of the experiment is to analyze the relationship between the therapeutic effect of neoadjuvant chemotherapy and ki-67 and analyze whether the ki-67 can be used as a predictor of the therapeutic effect of neoadjuvant chemotherapy.Objects:1.Analyze the differences between the expression of ki-67 in breast cancer before and after neoadjuvant chemotherapy,to understand the impact of neoadjuvant chemotherapy on the expression of ki-67.2.Analyze the relationship between expression of ki-67 and efficacy of neoadjuvant chemotherapy,to study whether ki-67 can be used as a predictor of the efficacy of neoadjuvant chemotherapy in breast cancer.Method:Collect the data of patients that accept systemic treatment in The Second Hospital of Dalian Medical University from January 2014 to December 2016 and analyze the collected data.The collected clinical factors including age,height,weight,menstrual,fertility and lactation status,family history of disease and breast disease history(including breast benign and malignant tumor),auxiliary examination on admission(including ultrasound,mammorgraphy,nuclear magnetic resonance imaging),nodes metastasis status,immunohistochemical indications of cancer before and after neoadjuvant chemotherapy,characteristics of tumor,preoperative auxiliary examination(including ultrasound,mammorgraphy,nuclear magnetic resonance imaging,etc)operation methods,etc.All the patients are diagnosed with invasive breast cancer by the hollow needle biopsy,and giving all the patients six cycles of docetaxel(75mg/?)+Epirubicin(75mg/?)regimens to chemotherapy.All the patients do operation 2-3 weeks after chemotherapy,using the immunohistochemical method to detect expression of ki-67 in the tumor before and after neoadjuvant chemotherapy.Analyze the differences between the expression of ki-67 in breast cancer before and after neoadjuvant chemotherapy,to understand the impact of neoadjuvant chemotherapy on the expression of ki-67 and analyze the relationship between expression of ki-67 and efficacy of neoadjuvant chemotherapy,to study whether ki-67 can be used as a predictor of the efficacy of neoadjuvant chemotherapy in breast cancer with Chi-square test.Results:Among the 124 breast cancer patients who received six cycles chemotherapy,6(4.8%)patients achieved for complete remission,including 2(1.6%)cases for pathological,83(67.0%)for partial response,35(28.2%)for stable disease,no one achieved for progressive disease,so the total effective rate is 71.8%.Analyze the differences between the expression of ki-67 in breast cancer before and after neoadjuvant chemotherapy,to understand the impact of neoadjuvant chemotherapy on the expression of ki-67 and analyze the relationship between expression of ki-67 and efficacy of neoadjuvant chemotherapy,to study whether ki-67 can be used as a predictor of the efficacy of neoadjuvant chemotherapy in breast cancer with Chi-square test.1.The expression of ki-67 shows a significant difference(P<0.05)before and after chemotherapy.The expression of ki-67 will decrease after neoadjuvant chemotherapy in breast Cancer.2.Among the 124 breast cancer patients who received six cycles chemotherapy,6 patients achieved for complete remission,including 2 cases for pathological,83 for partial response,35 for stable disease,no one achieved for progressive disease.The expression of ki-67 and efficacy of neoadjuvant chemotherapy is positively(P<0.05).3.The efficacy of neoadjuvant chemotherapy with reduced expression of ki-67 higher than that of no-reduced expression for ki-67(P<0.05).Conclusions:Ki-67 can effectively evaluate the efficacy of neoadjuvant chemotherapy and it can be used as reliable bases for the clinical selection of effective neoadjuvant chemotherapy for the treatment of breast cancer.