PDF(Pubmed)
Abstract：
Biomarkers such as hormone receptors (HR) and human epidermal growth factor receptor2 (HER2) may change after neoadjuvant chemotherapy (NAC) in breast cancer patients. The aim of this study was to investigate the rates of receptor change after NAC and to evaluate the prognostic impact of change. Patients with breast cancer who received NAC were included in the study. Changes in pathological findings (ER, PR, HER-2, Ki-67, grade) before and after NAC were examined. In addition, the effect of receptor exchange on prognosis was evaluated. Kaplan Meier analysis was used for survival analyses. Study was approved by Ethics Board of Tepecik Training and Research Hospital (Decision number 2021/10-02). We confirm that all methods were performed in accordance with relevant named guidelines and regulations. The study included 203 female patients. When pathological findings before and after NAC were compared, significant regression was found in grade and Ki-67 values (p = 0.003, p < 0.001). ER change rate was 11.8%, PR change rate was 24.6% and HER-2 change rate was 12.5%. No significant correlation was found between ER, PR and HER-2 changes and prognosis. The pathological T stage after NAC being 1 or 2, no lymph nodes detected, and the tumor grade being 1 or 2 were independent variables related to survival (p: 0.002, p: 0.014, p < 0.001). In patients with breast cancer, it would be appropriate to re-evaluate the HER-2 and HR status of the surgical specimen following NAC, especially in initially negative patients. The correlation of receptor discordance with prognosis is not clear and more extensive studies are needed.
摘要：
乳腺癌患者新辅助化疗（NAC）后，激素受体（HR）和人表皮生长因子受体2（HER2）等生物标志物可能发生变化。这项研究的目的是研究NAC后受体变化的速率，并评估变化对预后的影响。接受NAC的乳腺癌患者被纳入研究。病理结果的变化（ER，PR,HER-2，Ki-67，等级）在NAC之前和之后进行检查。此外,评估受体交换对预后的影响.KaplanMeier分析用于生存分析。研究得到了Tepecik培训和研究医院伦理委员会的批准（决定号2021/10-02）。我们确认所有方法均按照相关命名指南和法规进行。该研究包括203名女性患者。当比较NAC前后的病理结果时，分级和Ki-67值呈显著回归(p=0.003,p<0.001).ER变化率为11.8%,PR变化率为24.6%,HER-2变化率为12.5%。ER之间没有发现显著的相关性，PR和HER-2的改变与预后有关。NAC后病理T分期为1或2期，未检出淋巴结，肿瘤分级为1级或2级是与生存率相关的独立变量(p:0.002,p:0.014,p<0.001)。在乳腺癌患者中，在NAC后重新评估手术标本的HER-2和HR状态是合适的，尤其是最初阴性的患者。受体不一致与预后的相关性尚不清楚，需要更广泛的研究。
