Surgery time interval and molecular subtype may influence Ki67 change after core needle biopsy in breast cancer patients.
Surgery time interval and molecular subtype may influence Ki67 change after core needle biopsy in breast cancer patients.
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DOI：
10.1186/s12885-015-1853-1
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发表时间：
2015-10-30
期刊：
影响因子：
3.8
通讯作者：
Shen K
中科院分区：
文献类型：
--
作者：
Chen X;Zhu S;Fei X;Garfield DH;Wu J;Huang O;Li Y;Zhu L;He J;Chen W;Jin X;Shen K
目的：探讨核心针活检(CNB)评估乳腺癌雌激素受体(ER)、孕激素受体(PR)、HER2和Ki67状态的准确性，并找出可能与CNB后Ki67值变化相关的因素。对276例配对的CNB和手术切除标本(SRS)进行了回顾性研究。分析临床病理因素以及CNB与手术之间的手术时间间隔(STI)，以确定CNB后Ki67值变化是否存在相关因素。肿瘤分为5种亚型：管腔A、管腔B-HER2-、管腔B-HER2+、三阴性(TN)和管腔HER2+。Ki67值变化以SRS减去CNB计算。CNB后STI平均4.5(1~37)d。CNB和SRS对ER、PR和HER2的评估具有良好的一致性。然而，Ki67在鼻咽癌中的表达水平明显高于鼻咽癌，分别为29.1%和26.2%(P <； 0.001)。单因素和多因素分析均显示STI和分子亚型与CNB后Ki67的改变有关。腔A瘤较B-HER2瘤Ki67升高更明显(6.2%比-0.1%，P = 0.014)。术后1~2天、3~4天和4天以上分别为-1.1%、2.1%和5.6%(P = 0.007)。对于TN和HER2+肿瘤，在STI ≤ 4天时Ki67的变化倾向于为0，而在STI ≥ 5天的患者中发现Ki67增加了7%。CNB能准确评估ER、PR、HER2和分子亚型状态。CNB后Ki67值显著升高，与STI及分子亚型有关。进一步的翻译研究需要考虑不同乳腺癌分子亚型中CNB后Ki67的变化。本文的在线版本(doi：10.1186/s12885-0151853-1)包含补充材料，授权用户可以使用。
To investigate the accuracy of core needle biopsy (CNB) in evaluating breast cancer estrogen receptor (ER), progesterone receptor (PR), HER2, and Ki67 status and to identify factors which might be associated with Ki67 value change after CNB. A retrospective study was carried out on 276 patients with paired CNB and surgically removed samples (SRS). Clinico-pathological factors as well as the surgery time interval (STI) between CNB and surgery were analyzed to determine whether there were factors associated with Ki67 value change after CNB. Five tumor subtypes were classified as follows: Luminal A, Luminal B-HER2-, Luminal B-HER2+, Triple Negative (TN), and HER2+. Ki67 value change was calculated as SRS minus CNB. Mean STI after CNB was 4.5 (1-37) days. Good agreement was achieved for ER, PR, and HER2 evaluation between CNB and SRS. However, Ki67 expression level was significantly higher in SRS compared with CNB samples: 29.1 % vs. 26.2 % (P < 0.001). Both univariate and multivariate analysis demonstrated that STI and molecular subtype were associated with a Ki67 change after CNB. Luminal A tumors experienced more Ki67 elevation than Luminal B-HER2- diseases (6.2 % vs -0.1 %, P = 0.014). Patients with longer STI after CNB had a higher Ki67 increase: -1.1 % within 1-2 days, 2.1 % with 3-4 days, and 5.6 % more than 4 days, respectively (P = 0.007). For TN and HER2+ tumors, the Ki67 change was apt to be 0 with STI ≤ 4 days, while a >7 % Ki67 increase was noticed in patients with STI ≥ 5 days. CNB was accurate in evaluating ER, PR, HER2, and molecular subtype status. Ki67 value significantly increased after CNB, which was associated with STI and molecular subtype. Further translational research needs to consider Ki67 changes following CNB among different breast cancer molecular subtypes. The online version of this article (doi:10.1186/s12885-015-1853-1) contains supplementary material, which is available to authorized users.