BACKGROUND & AIMS:
: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.
背景与目标:
: 在新佐剂环境中,可以获得三个Ki-67参数: 治疗前Ki-67,治疗后Ki-67以及治疗前和治疗后之间的Ki-67变化。不确定这三个参数中哪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后进行紫杉烷化疗和随后进行乳腺癌手术的患者。通过免疫组织化学 (IHC) 将患者分为四种亚型 (Luminal A,Luminal B,三重阴性和HER2)。用IHC检查治疗前的芯针样品和治疗后的手术切除标本中的Ki-67。比较每种亚型之间的无复发生存率 (RFS)。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管腔B (8.3%) 和管腔A (3.8%) 亚型 (p <0.0001)。在腔A,腔B,三阴性和HER2亚型中分别观察到58.5,83.4,70.2和74.2% 患者的Ki-67降低。在多变量分析中,治疗前后的Ki-67变化是独立的预后因素,但治疗前Ki-67和治疗后Ki-67不是独立的预后因素。Luminal B (81.4 vs. 50.0%,p = 0.006),三阴性 (74.8 vs. 43.5%,p = 0.006) 和HER2 (82.7 vs. 59.0%,p = 0.009) 的Ki-67降低和未降低的患者之间的RFS显着不同。然而,对于Luminal A,RFS的差异与Ki-67的变化无关 (78.8 vs. 75.3%,p = 0.193)。新辅助化疗前后的Ki-67变化是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不是独立的预后因素。