In a neoadjuvant setting, three parameters for Ki-67 could be obtained: pre-treatment Ki-67, post-treatment Ki-67 and Ki-67 change between pre- and post-treatments. It is uncertain which of the three parameters has the greatest prognostic significance, and whether this parameter has significance in each subtype of breast cancer. A total of 385 patients who received neoadjuvant anthracycline followed by taxane chemotherapy and subsequent surgery for breast cancer were analyzed retrospectively. By immunohistochemistry (IHC), patients were divided into four subtypes (Luminal A, Luminal B, Triple negative, and HER2). Ki-67 was examined by IHC in pre-treatment core needle samples and post-treatment surgical excision specimens. The relapse-free survival (RFS) rate was compared among each subtype. The median follow-up period was 56 months. The rate of pathological complete response was higher for HER2 (34.8 %) and Triple negative (24.3 %) subtypes than for Luminal B (8.3 %) and Luminal A (3.8 %) subtypes (p < 0.0001). A reduction in Ki-67 was observed in 58.5, 83.4, 70.2, and 74.2 % of patients in the Luminal A, Luminal B, Triple negative, and HER2 subtypes, respectively. Ki-67 change between pre- and post-treatments was an independent prognostic factor, but pre-treatment Ki-67 and post-treatment Ki-67 were not independent prognostic factors in a multivariate analysis. The RFS was significantly different between patients whose Ki-67 was reduced and those not reduced for Luminal B (81.4 vs. 50.0 %, p = 0.006), Triple negative (74.8 vs. 43.5 %, p = 0.006) and HER2 (82.7 vs. 59.0 %, p = 0.009). However, for Luminal A, the difference in RFS was not associated with changes of Ki-67 (78.8 vs. 75.3 %, p = 0.193). Ki-67 change between pre- and post-neoadjuvant chemotherapy is an independent prognostic factor in patients of Luminal B, Triple negative, and HER2 subtypes. Pre-treatment Ki-67 and post-treatment Ki-67 were not independent prognostic factors in a multivariate analysis.

译文

:在新辅助条件下,可以获得Ki-67的三个参数:治疗前Ki-67,治疗后Ki-67和Ki-67在治疗前和治疗后的变化。尚不确定这三个参数中的哪一个具有最大的预后意义,以及该参数在每种乳腺癌亚型中是否具有意义。回顾性分析了总共385例接受新辅助蒽环类药物,紫杉烷化学疗法以及随后的乳腺癌手术的患者。通过免疫组织化学(IHC),将患者分为四个亚型(A型,B型,三阴性和HER2型)。 IHC在预处理核心针样品和治疗后手术切除样品中对Ki-67进行了检查。比较了每个亚型的无复发生存率。中位随访期为56个月。 HER2(34.8%)和三阴性(24.3%)亚型的病理完全缓解率高于Luminal B(8.3%)和Luminal A(3.8%)亚型(p <0.0001)。在Luminal A,Luminal B,三阴性和HER2亚型的患者中,分别有58.5%,83.4%,70.2%和74.2%的患者观察到Ki-67降低。在多变量分析中,治疗前后Ki-67的变化是独立的预后因素,但治疗前Ki-67和治疗后Ki-67并非独立的预后因素。对于Luminal B患者,Ki-67降低和未降低的患者的RFS显着不同(81.4 vs. 50.0%,p = 0.006),三阴性(74.8 vs. 43.5%,p = 0.006)和HER2(82.7vs。 59.0%,p = 0.009)。但是,对于Luminal A,RFS的差异与Ki-67的变化无关(分别为78.8%和75.3%,p = 0.193)。新辅助化疗前后的Ki-67改变是Luminal B,三阴性和HER2亚型患者的独立预后因素。在多变量分析中,治疗前Ki-67和治疗后Ki-67并非独立的预后因素。

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