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中华普通外科学文献(电子版) ›› 2011, Vol. 05 ›› Issue (06) : 497 -502. doi: 10.3877/cma.j.issn.1674-0793.2011.06.009

所属专题: 文献

论著

新辅助化疗对乳腺癌生物学指标表达的影响
贾卫娟1, 苏逢锡1,(), 曾韵洁2, 李丽娟3   
  1. 1. 510630 广州,中山大学孙逸仙纪念医院乳腺肿瘤科
    2. 510630 广州,中山大学孙逸仙纪念医院病理科
    3. 510630 广州,中山大学公共卫生学院医学统计和流行病学系
  • 收稿日期:2011-02-26 出版日期:2011-12-01
  • 通信作者: 苏逢锡
  • 基金资助:
    国家自然科学基金青年项目(30901767)

Effect of neoadjuvant chemotherapy on expression of biological markers in breast cancer

Wei-juan JIA1, Feng-xi SU1,(), Yun-jie ZENG2, Li-juan LI3   

  1. 1. Departemt of Breast Cancer, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, 510120 Guangzhou, China
  • Received:2011-02-26 Published:2011-12-01
  • Corresponding author: Feng-xi SU
  • About author:
    Corresponding author: SU Feng-xi, Email:
引用本文:

贾卫娟, 苏逢锡, 曾韵洁, 李丽娟. 新辅助化疗对乳腺癌生物学指标表达的影响[J/OL]. 中华普通外科学文献(电子版), 2011, 05(06): 497-502.

Wei-juan JIA, Feng-xi SU, Yun-jie ZENG, Li-juan LI. Effect of neoadjuvant chemotherapy on expression of biological markers in breast cancer[J/OL]. Chinese Archives of General Surgery(Electronic Edition), 2011, 05(06): 497-502.

目的

探讨新辅助化疗对评估原发性乳腺癌空心针穿刺活检(CNB)和手术切除标本(SES)生物学指标的影响。

方法

152例原发性乳腺癌患者纳入本研究。其中化疗组99例,手术组53例。采用免疫组织化学(IHC)方法比较152例CNB和SES采样组织标本中雌激素受体(ER)、孕激素受体(PR)、人表皮生长因子2(Her2)、Ki67、p53和TopoⅡ的表达,评估CNB在乳腺癌生物学指标检测中的准确性。

结果

CNB和SES在评估是否接受过新辅助化疗乳腺癌生物学指标方面具有良好的一致性,K值> 0.6。手术组CNB对生物学指标评估的准确性达到87%~91%,化疗组的准确性78%~95%。但新辅助化疗对ER、PR、Her2、p53和Ki67表达的影响差异无统计学意义(P > 0.05),两组间比较TopoⅡ表达差异有统计学意义(P < 0.05)。

结论

CNB和SES在评估乳腺癌生物学指标上的一致性较好,CNB评估乳腺癌生物学指标的准确性高。新辅助化疗对乳腺癌生物学指标的影响较小。

Objective

To determine the accuracy of biological markers expression in core needle biopsies(CNB) compared with surgically excised specimens(SES) and the influence of preoperative chemotherapy on these markers expression.

Methods

One hundred and fifty-two of 170 patients were analyzed. Ninty-nine women received neoadjuvant chemotherapy, and 53 patients underwent immediate surgery. Estrogen(ER) and progesterone receptor(PR), Her2, Ki67, p53 and Topo Ⅱ in biopsy tissue and surgically removed specimens were assessed using immunohistochemistry staining and calculated accuracy and kappa value.

Results

The assessment of biological markers expression can be performed on CNB and correlated well with subsequent SES regardless of patients with or without preoperative chemotherapy (K > 0.6), although the concordance rate in patients without preoperative chemotherapy was found to be higher for biomarkers expression compared to women with preoperative chemotherapy. The accuracy of CNB was 87%-91% in patients without neoadjuvant, and 78%-95% with neoadjuvant. No significant deference was observed about the effect of neoadjuvant chemotherapy on ER, PR, Her2, Ki67and p53, except Topo Ⅱ.

Conclusions

The agreement of breast cancer biomarkers expression detected in CNB and SES is high. The accuracy of biomarkers measurement in CNB is good. The effect of neoadjuvant chemotherapy on biological markers is small.

图1 原发性乳腺癌生物学指标表达(EnVision,×100)
表1 CNB和SES检测乳腺癌组织生物学指标的一致性
表2 新辅助化疗对乳腺癌组织生物学指标的影响(例)
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