Research of relationship between the change of molecular marker of breast cancer after neoadjuvant chemotherapy and therapeutic effect

doi:10.3877/cma.j.issn.1673-9450.2017.02.008

Abstract

Abstract:

Objective

To research whether the changes of estrogen receptor (ER) , progesterone receptor (PR), HER2 associate with the efficacy, during the course of neoadjuvant chemotherapy(NAC)(anthracycline and docetaxel), and to research whether these changes will affect the molecular subtypes.

Methods

One hundred and thirty seven cases of patients given NAC (anthracycline and docetaxel) were retrospectively analyzed from November 2011 to June 2015 in the Affiliated Hospital of Academy of Military Medical Sciences. ER, PR, HER2 and Ki67 expression were tested by immunohistochemistry.According to immunohistochemistry results, the cases were divided into 4 molecular subtypes: Luminal A, Luminal B, triple negative and HER2 positive. Changes of ER, PR, HER2 and Ki67 expression and molecular subtypes after neoadjuvant chemotherapy were tested by Chi-square test and Fisher′s exact test, and Kappa test was used to test the consistency of molecular markers and molecular subtypes before and after NAC.

Results

Concordance rate of ER, PR, HER2 and Ki67 were 88.32%, 83.21%, 94.16% and 75.91 respectively.There was no significant difference in ER, PR and HER2 before and after NAC(P values were all more than 0.05). Ki67 average value had fallen from 35.75% to 19.12% after NAC(P<0.05). Molecular subtypes would haven not been changed after NAC, except for cases with Hormone receptors(HR)positive and HER2 negative (P=0.488). Concordance rate of molecular subtypes between pre-NAC biopsies and post-NAC specimens was 57.66% (Kappa=0.4020).

Conclusion

NAC leads to a decrease of Ki67 value in invasive breast cancer cases, and makes an effect on tumors with molecular subtype of HR+ , HER2-.

Key words: Breast neoplasms, Neoadjuvant therapy, Receptors, Estrogen, Receptors, Progesterone, Genes, erbB-2

Sheng Chen, Yan Huang, Ye Wang, Weiwei Liu, Jianhua Zhang, Huaitao Wang, Maosheng Dong. Research of relationship between the change of molecular marker of breast cancer after neoadjuvant chemotherapy and therapeutic effect[J]. Chinese Journal of Injury Repair and Wound Healing(Electronic Edition), 2017, 12(02): 113-117.

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URL: https://zhssyxfzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1673-9450.2017.02.008

https://zhssyxfzz.cma-cmc.com.cn/EN/Y2017/V12/I02/113

Figures/Tables 4

References 12

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时间	ER		PR		HER2		Ki67
时间	阳性	阴性	阳性	阴性	阳性	阴性	≤14%	>14%
NAC前	101	36	84	53	10	127	33	104
NAC后	99	38	77	60	7	130	99	38
χ²值	0.095		1.182		0.352		13.234
P值	0.786		0.390		0.564		<0.05
时间	HR		分子分型
时间	阳性	阴性	Luminal A	LuminalB HER2-	Luminal B HER2＋	三阴性	HER2阳性
NAC前	106	31	54	46	7	26	4
NAC后	103	34	92	10	3	28	4
χ²值	0.235		34.707
P值	0.670		<0.01

时间	ER		PR		HER2		Ki67
时间	阳性	阴性	阳性	阴性	阳性	阴性	≤14%	>14%
NAC前	101	36	84	53	10	127	33	104
NAC后	99	38	77	60	7	130	99	38
χ²值	0.095		1.182		0.352		13.234
P值	0.786		0.390		0.564		<0.05
时间	HR		分子分型
时间	阳性	阴性	Luminal A	LuminalB HER2-	Luminal B HER2＋	三阴性	HER2阳性
NAC前	106	31	54	46	7	26	4
NAC后	103	34	92	10	3	28	4
χ²值	0.235		34.707
P值	0.670		<0.01

NAC前		NAC后(例)		一致率(%)	McNemar χ ²检验	Kappa值	P值
NAC前		阴性	阳性	一致率(%)	McNemar χ ²检验	Kappa值	P值
ER		?	?	88.32	0.6171	0.7039	<0.01
?	阴性	29	7	?	?	?	?
?	阳性	9	92	?	?	?	?
PR		?	?	83.21	0.1444	0.6526	<0.01
?	阴性	44	8	?	?	?	?
?	阳性	15	70	?	?	?	?
HER2		?	?	94.16	0.1573	0.5260	<0.01
?	阴性	124	2	?	?	?	?
?	阳性	6	5	?	?	?	?
Ki67		?	?	75.91	<0.01	0.5272	<0.01
?	≤14%	63	2	?	?	?	?
?	>14%	31	41	?	?	?	?
HR		?	?	92.70	0.5271	0.7962	<0.01
?	阴性	27	4	?	?	?	?
?	阳性	6	100	?	?	?	?

NAC前		NAC后(例)		一致率(%)	McNemar χ ²检验	Kappa值	P值
NAC前		阴性	阳性	一致率(%)	McNemar χ ²检验	Kappa值	P值
ER		?	?	88.32	0.6171	0.7039	<0.01
?	阴性	29	7	?	?	?	?
?	阳性	9	92	?	?	?	?
PR		?	?	83.21	0.1444	0.6526	<0.01
?	阴性	44	8	?	?	?	?
?	阳性	15	70	?	?	?	?
HER2		?	?	94.16	0.1573	0.5260	<0.01
?	阴性	124	2	?	?	?	?
?	阳性	6	5	?	?	?	?
Ki67		?	?	75.91	<0.01	0.5272	<0.01
?	≤14%	63	2	?	?	?	?
?	>14%	31	41	?	?	?	?
HR		?	?	92.70	0.5271	0.7962	<0.01
?	阴性	27	4	?	?	?	?
?	阳性	6	100	?	?	?	?

NAC前	NAC后(例)				一致率(%)	Kappa值	P值
NAC前	Luminal A	Luminal B	三阴性	HER2阳性	一致率(%)	Kappa值	P值
Luminal A	33	2	0	0	?	?	?
Luminal B	44	24	4	0	57.66	0.4020	<0.01
三阴性	3	1	20	2	?	?	?
HER2阳性	0	1	1	2	?	?	?

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