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目的探讨TOPⅡ联合p53和Ki-67的表达对局部晚期乳腺癌化疗敏感性的预测价值。方法采用免疫组化方法检测90例乳腺癌患者不同分子分型的TOPⅡ、p53和Ki-67的表达状况,比较不同TOPⅡ、p53及Ki-67表达状况患者接受新辅助化疗的疗效差异。结果 Ki-67表达阳性率在HER2过表达型、Basal-like型、腺腔A型和腺腔B型之间的差异具有统计学意义(χ2=38.877,P=0.000),其中HER2过表达型和Basal-like型高于腺腔A型和腺腔B型;TOPⅡ及p53的表达表达阳性率在4种分子分型间的差异无统计学意义(χ2=7.105,P=0.069;χ2=7.105,P=0.069)。TOPⅡ和Ki-67表达阳性者的新辅助化疗疗效优于表达阴性者χ2=18.28,P=0.000;χ2=6.64,P=0.009;而p53的表达状况与新辅助化疗的敏感性无关。结论 HER2过表达型和Basal-like型乳腺癌患者对新辅助化疗敏感,疗效好;TOPⅡ表达阳性并Ki-67表达阳性可作为乳腺癌临床化疗患者敏感性生物学指标。
Objective To investigate the predictive value of TOP Ⅱ combined with p53 and Ki-67 in chemosensitivity of locally advanced breast cancer. Methods Immunohistochemistry was used to detect the expression of TOPⅡ, p53 and Ki-67 in different molecular types in 90 patients with breast cancer. The differences in the efficacy of neoadjuvant chemotherapy between patients with different TOPⅡ, p53 and Ki-67 expression were compared. Results The positive rate of Ki-67 expression in HER2 overexpression, Basal-like type, gland type A and gland type B was significantly different (χ2 = 38.877, P = 0.000) And Basal-like type were higher than those in type A and type B of glandular cavity. There was no significant difference in the expression rates of TOPⅡ and p53 between the four molecular types (χ2 = 7.105, P = 0.069; χ2 = 7.105 , P = 0.069). Neoadjuvant chemotherapy with positive expression of TOPⅡ and Ki-67 showed better curative effect than χ2 = 18.28, P = 0.000; χ2 = 6.64, P = 0.009; however, the expression of p53 was not related to the sensitivity of neoadjuvant chemotherapy. Conclusions Patients with HER2 overexpression and Basal-like breast cancer are sensitive to neoadjuvant chemotherapy and have good curative effect. Positive TOPⅡ and Ki-67 positive can be used as sensitive biological indicators in patients with clinical breast cancer.