Correlation Between EGFR And P53 In Neoadjuvant Chemotherapy For Triple-negative Breast Cancer

ObjectivesAs a highly heterogeneous malignant tumor,triple-negative breast cancer h as the characteristics of strong invasion,easy recurrence and metastasis,and po or prognosis.It accounts for 15%-20%of breast cancer incidence and its mort ality rate is quite high.Because there is no targeted treatment target at present,the treatment method is nothing more than the choice of conventional method s of surgery,radiotherapy and chemotherapy,of which chemotherapy accounts for a large proportion.Clinically,for patients with triple-negative breast cancer who have no chance of surgery or are willing to conserve breast cancer local ly,neoadjuvant chemotherapy before surgery has gradually become the mainstr eam choice,but at the same time they must face risk of tumor resistance,dise ase progression and metastasis during chemotherapy.Therefore,the impact of n eoadjuvant chemotherapy resistance on triple negative breast cancer patients has gradually attracted attention in daily work.In recent years,EGFR and P53 ex pression and breast cancer recurrence,metastasis,prognosis,survival and other research achievements have been outstanding,but currently whether domestic E GFR and P53 expression can affect the efficacy and predict the prognosis of n eoadjuvant chemotherapy for triple negative breast cancer patients.The literatur e report is relatively lacking.Based on this background,this article aims to un derstand the pathological characteristics of triple negative breast cancer patients such as age,family history,menstrual status,tumor size,tissue grade,axillary lymph node metastasis,and immunohistochemical expression of EGFR and P53 and analyze the correlation between them To explore the influence and predi ctive value of pathological parameters on objective response rate and complete pathological response of neoadjuvant chemotherapy for triple-negative breast c ancer,and to provide a reference for the resistance of established protocols du ring neoadjuvant chemotherapy of triple-negative breast cancer.MethodsThis retrospective study included 85 female patients admitted to the Depar tment of Breast Surgery of Zhengzhou University People's Hospital from Janua ry 2015 to January 2018.Both the pathological and immunohistochemical cons ultations were triple negative breast cancer,with complete data and no distant metastases.After neoadjuvant chemotherapy,they received standardized surgery and/or radiation therapy according to the changes in the condition(for patient s with breast surgery and other surgical methods)Accepted within 1 month an d completed on time).Integrate imaging,puncture,and postoperative pathologic al tissue wax blocks as basic data,analyze the characteristics of each paramete r,apply immunohistochemical two-step method to detect the expression of EG FR and P53,and use ?2 test or Fisher exact probability method to analyze E GFR and The correlation between immunohistochemical expression of P53 and each parameter,and the effect of each parameter on the objective response ra te of neoadjuvant chemotherapy for triple-negative breast cancer.Multivariate a nalysis was used to understand the predictive value of neoadjuvant chemothera py by binary logistic regression.P<0.05 is considered statistically significant.ResultsAmong the 85 patients included,the age of onset of TNBC ranged from 28 to 59 years,with a median age of 43 years and an average age of(42.75±7.079)years.Non-menopausal women are the mainstream population.The path ological type is more common in invasive ductal carcinoma.The histological g rade is ?-?,the tumor diameter ranges from 1.8 to 6.5 cm,and the absolute proportion is above T2 stage.56.5%of patients have armpits before NAC.L ymph node metastasis,63.5%of patients underwent modified radical mastecto my for breast cancer,27.1%of patients underwent breast-sparing axillary radio al mastectomy and sentinel lymph node biopsy,and the remaining patients rec eived other surgical treatments(breast-breast mastectomy and sentinel Lymph n ode biopsy,skin-preserving mastectomy,breast-preserving breast and nipple radi cal mastectomy,etc.).Among the 85 patients included,the positive expression of EGFR account ed for 65.9%,with age(?2=10.291,P=0.011),tumor size(?2=12.953,P=0.011),a xillary lymph node status(x2=8.760,P=0.007),There is a correlation.and there i s no statistical significance between the family history,menstrual status,pathol ogical type,and histological grading parameters,showing no correlation(P>0.05);P53 positive expression accounts for 81.2%,and age(?2=10.653,P=0.010),menstrual status(P=0.001),and no correlation with other parameters such as f amily history,pathological type,tumor size,axillary lymph node metastasis,histol ogical grade no statistical significance(P>0.05).Among the 85 patients included,univariate analysis showed that tumor siz e(x2=14.677,P<0.001)and EGFR expression(P<0.001)were significantly corre lated with the adverse clinical response of neoadjuvant chemotherapy.There w as no statistically significant difference between other clinicopathological param eters and the objective response rate of NAC in TNBC patients,showing no c orrelation(P>0.05).Multivariate analysis showed that only tumor size can be used as a predictor of NAC objective response rate in TNBC patients(P<0.05).Among the 85 patients included,15 patients(17.6%)achieved PCR after NAC.The results of single factor analysis showed age size(?2=7.277,P<0.048),menstrual status(P=0.035),tumor size(x2=13.902,P<0.001),axillary lymph no de status(?2=8.784,P=0.009),EGFR expression(x2=28.414,P<0.001)were corre lated with post-NAC PCR in TNBC patients,the difference was statistically si gnificant(P<0.05),there is no statistically significant difference between other types of clinical pathological parameters and post-NAC PCR in TNBC patients,showing no correlation(P>0.05).Multivariate analysis showed that only EGF R expression can be used as a predictor of NAC efficacy in TNBC patients(P<0.05).Conclusions(1)The expression of EGFR is an independent predictor of PCR after N AC in TNBC patients,but it has no predictive value for the objective respons e rate of NAC.(2)The expression of P53 had no significant effect and predictive value o n NAC objective response rate and PCR in TNBC patients.