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目的:观察新辅助化疗用于乳腺浸润性导管癌的临床效果，分析化疗后乳腺癌组织中雌激素受体（estrogen receptor，ER）、孕激素受体（progesterone receptor，PR）、人表皮生长因子受体2（human epidermal growth factor receptor-2，HER-2）及Ki67表达的变化。方法:选择2014年1月至2020年12月华北理工大学附属医院收治的乳腺浸润性导管癌符合纳入与排除条件的83例患者的临床资料，其中，Luminal A型30例，Luminal B型31例，HER-2阳性型10例，三阴型12例。观察不同分子亚型患者治疗的临床效果，同时检测新辅助化疗前后病变组织中ER、PR、HER-2和Ki67表达的情况，进行回顾性病例对照研究。两组间比较采用n χn 2检验、配对n χn 2检验和Fisher精确概率法。n 结果:临床总有效58例，总有效率为69.8%（58/83），病理完全缓解（pathological complete response，pCR）9例，占比为10.8%（9/83）。新辅助化疗后临床有效最高为Luminal B型26例，达pCR最高为三阴型3例。病理学结果显示相对于治疗前，新辅助化疗后ER（阳性表达增加6例，n χ2=1.03，n P=0.310）、PR（阳性表达增加8例，n χ2=1.56，n P=0.210）和HER-2（阳性表达减少2例，n χ2=0.10，n P=0.748）表达无明显变化；Ki67表达化疗后25例（30.1%）较化疗前59例（71.1%）明显下降，差异有统计学意义（n χ2=27.85，n P0.75），一致率为91.9%，化疗前后一致性好。临床有效比较，化疗后HER-2表达59例不变（临床有效48例）、9例上调（临床有效4例）、15例下调（临床有效6例），组间比较差异有统计学意义（n χ2=12.82，n P=0.002）；Ki67表达35例不变（临床有效20例）、7例上调（临床有效2例）、41例下调（临床有效36例），组间比较差异有统计学意义（n χ2=14.63，n P=0.001）。n 结论:新辅助化疗应用于乳腺浸润性导管癌的临床治疗效果理想，Luminal B型临床有效率最高，三阴型pCR率最高。且能够显著降低Ki67的表达，HER-2、Ki67下调对临床有效率有意义。“,”Objective:To observe the clinical effect on patients of invasive ductal carcinoma of the breast by neoadjuvant chemotherapy, and to analyze the changes of estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor-2 (HER-2) and Ki67 in neoplasm.Methods:A total of 83 patients which were treated by neoadjuvant chemotherapy in breast invasive ductal carcinoma diagnosed were selected in North China University of Science and Technology Affiliated Hopital from January 2014 to December 2020. There were 30 cases of Luminal type A, 31 cases of Luminal type B, 10 cases of HER-2 positive type and 12 cases of triple negative type. To observe the clinical effect of different molecular subtypes, detect the expression of Er, PR, HER-2 and Ki67 in pathological tissues before and after neoadjuvant chemotherapy, and conduct a retrospective case-control study. Comparison between the two groups use n χ2 test, matched n χ2 and accurate probability method.n Results:Fifty-eight cases were clinically effective, the total effective rate was 69.8% (58/83), and 9 cases were pathological complete response (pCR), accounting for 10.8% (9/83). After neoadjuvant chemotherapy, the highest clinical efficacy was luminal type B in 26 cases, and the highest PCR was triple negative type in 3 cases. The pathological results showed that the expression of ER (6 cases of positive expression were increased, n χ2=1.03,n P=0.310), PR (8 cases of positive expression were increased, n χ2=1.56, n P=0.210) and HER-2 (2 cases of positive expression were decreased, n χ2=0.10, n P=0.748) was not different before and after neoadjuvant chemotherapy. The expression of Ki67 was decreased in 25 cases (30.1%) after chemotherapy compared with 59 cases (71.1%) before chemotherapy (34 cases of positive expression were decreased, n χ2=27.85, n P0.75), the consistency rate was 91.9%. The consistency was idea before and after chemotherapy. Five cases were added after Luminal type A chemotherapy, all of which were transformed from Luminal type B, but the kappa value was 0.919 (n P>0.75), and the consistency rate was 91.9%,The consistency before and after chemotherapy was good. After chemotherapy, HER-2 expression remained unchanged in 59 cases (clinically effective in 48 cases), up-regulated in 9 cases (clinically effective in 4 cases) and down regulated in 15 cases (clinically effective in 6 cases)(n χ2=12.82, n P=0.002). Ki67 expression remained unchanged in 35 cases (20 cases were clinically effective), up-regulated in 7 cases (2 cases were clinically effective) and down regulated in 41 cases (36 cases were clinically effective)(n χ2=14.63, n P=0.001).n Conclusion:The clinical effect of neoadjuvant chemotherapy in the treatment of breast invasive ductal carcinoma is ideal. The clinical effective rate of Luminal B type is the highest, and the pCR rate of triple negative type is the highest.And it can significantly reduce the expression of Ki67. The down-regulation of HER-2 and Ki67 is significant for clinical efficiency.