Biomarkers Predicting Pathologic Complete Response to Neoadjuvant Chemotherapy in Breast Cancer
Biomarkers Predicting Pathologic Complete Response to Neoadjuvant Chemotherapy in Breast Cancer
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DOI：
10.1093/ajcp/aqw045
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发表时间：
2016-06-01
影响因子：
3.5
通讯作者：
Aneja, Ritu
中科院分区：
文献类型：
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作者：
Li, Xiaoxian Bill;Krishnamurti, Uma;Aneja, Ritu
目的：最近的研究表明，乳腺癌新辅助化疗的病理完全反应（pCR）与生存和预后有很强的相关性。方法：回顾性分析2012 - 2014年237例接受新辅助化疗的乳腺癌患者的临床资料。寻求pCR与雌激素受体（ER）、孕激素受体（PR）和HER2状态之间的相关性；诺丁汉和核等级；肿瘤小管形成；有丝分裂分数;Ki67指数;肿瘤和间质淋巴细胞浸润（TLI和SLI）。结果：237例中，104例（43.9%）pCR成功。与腔型（ER+或PR+和HER2 -）相比，HER2+和三阴性乳腺癌（TNBC）亚型的pCR率更高。ER和PR阴性、HER2阳性、Nottingham 3级、TLI和SLI升高、有丝分裂计数高、Ki67评分与整个队列的pCR显著相关。在多变量分析中，TLI和SLI与HER2+和TNBC亚型的pCR显著相关，而在luminal亚型中，没有生物标志物与pCR相关。结论：除了常规评估的病理参数和生物标志物外，TLI和SLI的评估可能有助于更好地选择HER2+和TNBC患者进行新辅助化疗。
Objectives:Recent studies have shown strong correlation of pathologic complete response (pCR) to neoadjuvant chemotherapy with survival and prognosis in breast cancers.Methods:Clinical data from 237 breast cancer patients who received neoadjuvant chemotherapy between 2012 and 2014 were reviewed.Correlations were sought between pCR and estrogen receptor (ER), progesterone receptor (PR), and HER2 status; Nottingham and nuclear grades; tumor tubule formation; mitotic score; Ki67 index; and tumoral and stromal lymphocytic infiltration (TLI and SLI, respectively).Results:Of the 237 cases, 104 (43.9%) achieved pCR. The HER2+ and triple negative breast cancer (TNBC) subtypes had higher pCR rates compared with the luminal subtype (ER+ or PR+ and HER2–). ER and PR negativity, HER2 positivity, Nottingham grade 3, increased TLI and SLI, high mitotic count and Ki67 score correlated significantly with pCR in the overall cohort. TLI and SLI correlated significantly with pCR in the HER2+ and TNBC subtypes in multivariate analysis, whereas no biomarkers correlated with pCR in the luminal subtype.Conclusions:In addition to the pathologic parameters and biomarkers already routinely assessed, evaluation of TLI and SLI may help to better select patients with HER2+ and TNBC for neoadjuvant chemotherapy.