首页|Ki-67 Change in Anthracyline-containing Neoadjuvant Chemotherapy Response in Breast Cancer
Ki-67 Change in Anthracyline-containing Neoadjuvant Chemotherapy Response in Breast Cancer
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Objective:Anthracycline-containing regimens are irreplaceable in neoadjuvant chemotherapy(NAC)for breast cancer(BC)at present.However,30％of early breast cancer(EBC)patients are resistant to anthracycline-containing chemotherapy,leading to poor prognosis and higher mortality.Ki-67 is associated with the prognosis and response to therapy,and it changes after NAC.Methods:A total of 105 BC patients who received anthracycline-containing NAC were enrolled.Then,the optimal model of Ki-67 was selected,and its predictive efficacy was analyzed.Immunohistochemistry(IHC)was used to determine the estrogen receptor(ER),progesterone receptor(PR),and human epidermal growth factor receptor 2(HER-2)status and Ki-67 level.Fluorescent in situ hybridization(FISH)was used to verify the HER-2 when the IHC score was 2+.Results:The post-NAC Ki67 level after treatment with anthracycline drugs was lower than pre-NAC Ki-67(19.6％±23.3％vs.45.6％±23.1％,P＜0.001).Furthermore,patients with the Ki-67 decrease had a border line higher pathological complete response(pCR)rate(17.2％vs.0.0％,P=0.068),and a higher overall response rate(ORR)(73.6％vs.27.8％,P＜0.001),when compared to patients without the Ki-67 decrease.The ΔKi-67 and ΔKi-67％were valuable markers for the prediction of both the pCR rate and ORR.The area under the curve(AUC)for ΔKi-67 on pCR and ORR was 0.809(0.698-0.921)and 0.755(0.655-0.855),respectively,while the AUC for ΔKi-67％on pCR and ORR was 0.857(0.742-0.972)and 0.720(0.618-0.822),respectively.Multivariate logistic regression model 1 revealed that ΔKi-67 was an independent predictor for both pCR[odds ratio(OR)=61.030,95％confidence interval(CI)=4.709-790.965;P=0.002]and ORR(OR=10.001,95％CI:3.044-32.858;P＜0.001).Multivariate logistic regression model 2 revealed that ΔKi-67％was also an independent predictor for both pCR(OR=408.922,95％CI=8.908-18771.224;P=0.002)and ORR(OR=5.419,95％CI=1.842-15.943;P=0.002).Conclusions:The present study results suggest that ΔKi67 and ΔKi67％are candidate predictors for anthracycline-containing NAC response,and that they may provide various information for further systematic therapy after surgery in clinical practice.
breast cancerchange in Ki-67neoadjuvant chemotherapyanthracycline,response
Zi-guo YANG、Le-hao REN、Feng WANG、Pi-lin WANG、Wen-yan WANG、Shu-ye LIN
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Department of General Surgery,Beijing Tian tan Hospital,Capital Medical University,Beijing 100070,China
Department of Critical Care Medicine,Union Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430022,China
Cancer Research Center,Beijing Chest Hospital,Capital Medical University/Beijing Tuberculosis and Thoracic Tumor Research Institute,Beijing 101149,China
Beijing Hospitals Authority Youth Programme,ChinaYoung Elite Scientist Sponsorship Program by Beijing Association for Science and Technology(BAST)
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