Multivariate Analyses Of The Correlation Between The Effectiveness Of Neoadjuvant Chemotherapy With Expression Of ER,PR,Her-2,Ki-67,Topo-â…¡ In Breast Cancer

Abstract Objective:We aimed to analyze the correlation between the clinical therapeutic effectiveness of neoadjuvant chemotherapy(NAC)with the expressions of estrogen receptor (ER), progesterone receptor (PR), Her-2, Ki-67, Topo-â…¡in pre-and post-NAC in breast cancer, and to assess the value of those expressions of protein for the prediction of effectiveness of NAC, in order to guide the further selection of drugs for NAC and individualized treatment.Methods:We retrospectively studied 61 breast cancer patients with NAC, for the clinical and pathological characteristics, the clinical therapeutic effectiveness and pathological changes of NAC,and the expressions of ER, PR, Her-2, Ki-67,Topo-â…¡in pre-and post-NAC, then to statistically analyze those relationships between the clinical effectiveness and pathological changes of NAC with the change of the expressions of ER, PR, Her-2, Ki-67, Topo-â…¡in pre-and post-NAC, and with the clinical and pathological features of breast cancer, such as menostasis, regimen of NAC,etc, with SPSS in chi-square test and then further analyze by logistic regression .Results:Total effective rate of NAC was 80.3%, there were stable disease( SD )patients 12, partial response( PR) patients 40,clinical complete response (cCR) patients 5, pathological complete response (pCR ) patients 4.The rate of pathological responses of NAC was 86.9%, there were no pathological responses 8, mild tissue reaction 22, midrange tissue reaction 18, Severe tissue reaction 13. Both the expressions of ER,PR,Ki-67, Topo-â…¡in pre-NAC, regimen of NAC, and the change of expressions of Her-2, Ki-67 in post-NAC, pathological responses, are all correlated with the efficacy of NAC, P<0.05. The CR rate was associated to the expressions of ER, Ki-67 in pre-NAC, regimen of NAC. Stratified analyze showed that: the choice of regimen of NAC has no correlation with the expressions of ER,PR , Her-2, Ki-67, Topo-â…¡in pre-NAC. The responses rate of regimen of NE was associated to the expressions of ER,PR, Ki-67 in pre-NAC, the response rate of regimen of CEF was associated to the expressions of PR ,Ki-67, Topo-â…¡in pre-NAC,while regimen of TEC was only related to Ki-67 in pre-NAC. Logistic regression analysis showed that the expressions of ER, PR,Ki-67 in pre-NAC, and pathological responses were relevant to the clinical therapeutic effectiveness of NAC .Conclusions:The clinical therapeutic effectiveness of NAC is positive, the expression of ER , PR, Ki-67in pre-NAC and pathological responses are all associated to the therapeutic effectiveness of NAC in breast cancer. In those low expressions of Topo-â…¡in pre-NAC cases, the efficacy of NAC was correlated with the regimen of NAC, regimen of NE and TEC had higher clinical effective rate than CEF regimen of orthodox. The combined detection of ER, PR,Ki-67and Topo-â…¡can contributed to predict the sensitiveness to NAC, to chose appropriate regimen of NAC and to improve the rate of clinical therapeutic effectiveness and pathological response.