三阴性乳腺癌每周紫杉醇＋卡铂新辅助化疗前后Ki-67表达水平的意义
2016年7月18日，英国《自然》旗下《科学报告》发表复旦大学附属肿瘤医院、上海医学院、生物医学研究院的研究报告，分析了三阴性乳腺癌每周紫杉醇＋卡铂新辅助化疗前后Ki-67表达水平的意义。
新辅助化疗是治疗局部进展期乳腺癌的主要治疗策略之一。该研究收集了280例II～III期三阴性乳腺癌患者的数据。所有患者均按照相同方案用每周紫杉醇＋卡铂治疗。总的病理学完全缓解率为33.9%。分类和线性Ki-67均与病理学完全缓解独立相关（P＜0.001）。Ki-67分类对于临床缓解、米勒-佩恩（MP）分级、淋巴结状态也存在统计学显著差异（均P＜0.001）。新辅助化疗后Ki-67显著降低似乎多见于缓解相对较好的患者。在非病理学完全缓解患者的多变量模型中，Ki-67降低对于疾病复发有独立预后价值（风险比：0.986，95%置信区间：0.978～0.994，P=0.001）。
该研究表明，Ki-67可能有助于三阴性乳腺癌进一步分为对化疗缓解不同的亚型，而且治疗后显著Ki-67降低可能提示非病理学完全缓解患者的较好预后。
Sci Rep. 2016 Jul 18;6:30091.
Value of Ki-67 expression in triple-negative breast cancer before and after neoadjuvant chemotherapy with weekly paclitaxel plus carboplatin.
Wang RX, Chen S, Jin X, Shao ZM.
Fudan University Shanghai Cancer Center/Cancer Institute, Shanghai, P.R. China; Shanghai Medical College, Fudan University, Shanghai, P.R. China; Institutes of Biomedical Science, Fudan University, Shanghai, P.R. China.
Neoadjuvant chemotherapy (NCT) is one of the main treatment strategies for patients with locally advanced breast cancer. In this study, we focused on the predictive and prognostic value of Ki-67 in triple-negative breast cancer (TNBC) patients who received NCT. Data from 280 patients with stage II-III TNBC were collected. All patients were treated according to the same protocol with weekly paclitaxel and carboplatin. The overall pCR rate was 33.9%. Both the categorical and linear Ki-67 were independently correlated with pCR (P<0.001). There were also statistically significant differences among Ki-67 categories with respect to clinical response (P<0.001), Miller-Payne (MP) grades (P<0.001), and node status (P<0.001). A significant reduction of Ki-67 after NCT was most likely observed in patients with a relatively better response. In the multivariate model for non-pCR patients, Ki-67 reduction presented an independent prognostic value for relapse of disease (HR=0.986, 95% CI: 0.978-0.994; P=0.001). This study had indicated that the primary Ki-67 might help in further classifying TNBCs into subtypes with different responses to chemotherapy and a significant reduction of Ki-67 after treatment could indicate a favorable prognosis in non-pCR patients.
PMID: 27426056
DOI: 10.1038/srep30091