Immunohistochemical Changes In Patients With Partial Remission After Breast Cancer Neoadjuvant Chemotherapy

Objective1.To investigate the changes of immunohistochemistry in patients with partial remission(PR)after neoadjuvant chemotherapy for breast cancer(NAC).2.By analyzing the changes of ER(estrogen receptor),PR(progestin receptor),HER-2(human epidermal growth factor receptor 2)and Ki67(cell proliferation nuclear antigen)in patients before and after NAC Predict the patient's prognosis and develop appropriate individualized treatments.MethodsA retrospective analysis was performed on 96 patients with neoadjuvant chemotherapy for breast cancer treated in our department's general surgery from July 2016 to July2019,and the patients were collected before the neoadjuvant chemotherapy.(1)To analyze the expression levels of ER,PR,HER-2 and Ki67 in pathoimmunohistochemistry before and after neoadjuvant chemotherapy.(2)The expressions of ER,PR,HER-2 and Ki67 in postoperative pathoimmunohistochemically assessed patients with partial remission after NAC were analyzed compared with those before chemotherapy.Result(1)Of 96 patients,20 patients achieved complete pathological response(p CR)(20.83%),and 76 patients were evaluated as PR(79.17%).The immunohistochemical changes of76 patients with partial remission before and after NAC were analyzed.there were 34 cases of ER(-),6 cases of ER(+)before NAC,10 cases of ER(++),26 cases of ER(+++),38 cases of ER(-),4 cases of ER(+)after NAC,12 cases of ER(++),22 cases of ER(++),12 cases of ER(+++)before and after NAC(15.79%),and the changes of estrogen receptor before and after NAC were not statistically significant(P>0.05).Similarly,the changes of progesterone receptor before and after NAC were not statistically significant(P>0.05).Ki67 before NAC was 44.75 ± 20.997,and Ki67 after NAC was 23.89 ±17.992,with statistically significant difference(P<0.05).46 cases showed high expression of Ki67 before NAC,30 cases showed low expression,18 cases showed high expression of Ki67 after NAC and 58 cases showed low expression.The changes of Ki67 before and after NAC were statistically significant(P<0.05).(2)In furth ER analysis,we found 2 cases of ER(-),4 cases of ER(+)before NAC,10 cases of ER(++),24 cases of ER(+++),3 cases of ER(-)after NAC,3 cases of ER(+)after NAC,12 cases of ER(++),22 cases of ER(++),6 cases of er expression changes before and after NAC(15.00%),and there was no statistical significance in ER expression changes before and after NAC(P>0.05).Similarly,the expression changes of PR before and after NAC had no statistical significance(P>0.05).Ki67 value before NAC was 40.63±20.976,and Ki67 value after neoadjuvant chemotherapy was 20.33±18.840,indicating that there was a statistical difference in Ki67 expression before and after NAC(P<0.05).(3)In her-2 overexpression group,the pre-NAC Ki67 value was 42.09±16.917,and the post-NAC Ki67 value was24.68±12.937,which showed that the difference in the expression of Ki67 before and after NAC was statistically significant(P<0.05).(4)The value of Ki67 in the first three negative groups of NAC is 60.71±20.555,and the value of Ki67 after NAC is 32.86±19.779,which shows that the difference in the expression of Ki67 before and after NAC is statistically significant(P<0.05).(5)The difference in Ki67 expression between premenopausal and postmenopausal patients after neoadjuvant chemotherapy was statistically significant(P <0.05).(6)The clinical stage II and III showed statistically significant differences in Ki67 expression after neoadjuvant chemotherapy(P <0.05).Conclusion(1)The level of Ki67 is related to the sensitivity of breast cancer cells to chemotherapy.Ki67 is an independent predictor of the effect of neoadjuvant chemotherapy.(2)Neoadjuvant chemotherapy can change the expression status of ER and PR,but the overall trend cannot be determined.(3)Neoadjuvant chemotherapy cannot change the expression status of HER-2.