|Table of Contents|

breast cancer,neoadjuvant chemotherapy,immunohistochemistry,molecular typing

Journal Of Modern Oncology[ISSN:1672-4992/CN:61-1415/R]

Issue:
2024 08
Page:
1445-1451
Research Field:
Publishing date:

Info

Title:
breast cancer,neoadjuvant chemotherapy,immunohistochemistry,molecular typing
Author(s):
Correlation between molecular typing and immunohistochemical expression changes of breast cancer before and after neoadjuvant chemotherapy and therapeutic efficacy
LI Hongen,LI Yuelong,LYU Peifeng,ZENG Yihui,LI Chengwei,ZHANG Li
Keywords:
Radiology Department; Guangdong Maternal and Child Health Care Hospital; Guangdong Guangzhou 510010; China.
PACS:
R737.9
DOI:
10.3969/j.issn.1672-4992.2024.08.013
Abstract:
Objective:To analyze the changes in molecular typing and immunohistochemical (IHC) expression of breast cancer before and after neoadjuvant chemotherapy (NAC),and to explore the possible related factors for the changes in IHC results after neoadjuvant therapy.Method:Clinical and case data of 151 patients with breast cancer who received NAC in our hospital from March 2014 to August 2022 were retrospectively collected.All patients underwent 4~6 cycles of neoadjuvant chemoradiotherapy and modified radical mastectomy or radical mastectomy.According to the Miller-Payne grading,patients were divided into pCR group and non-pathologic complete response (non-pCR) group.The changes of IHC indexes,such as estrogen receptor (ER),progesterone receptor (PR),human epidermal growth factor receptor 2 (Her-2),cell proliferation antigen (Ki-67) and molecular typing of patients in the non-pCR group after NAC were observed.χ2 test was used to analyze the differences of IHC indexes and molecular typing in the non-pCR group before and after neoadjuvant chemotherapy.Pearson correlation coefficient was used to examine the changes of IHC expression and molecular typing after NAT.The relationship between pCR and clinicopathological features of neoadjuvant chemotherapy patients was analyzed.The clinicopathological features mainly included age,involvement of mammary gland,pathological type,immunohistochemical markers and molecular typing.Multivariate Logistic regression analysis was used to examine the PCR-related influencing factors.Result:There were 151 patients with breast cancer,6 with Luminal A,81 with Luminal B,29 with Her-2 overexpression,and 35 with triple-negative.After NAC,pCR patients accounted for 40.4%(61/151) and non-pCR patients accounted for 59.6%(90/151).In 90 non-pCR patients,compared with before treatment,ER(positive expression did not change,χ2=0.000,P=1.000),PR(positive expression decreased in 9 cases,χ2=2.730,P=0.098) and Her-2(positive expression decreased in 3 cases,χ2=0.284,P=0.594) after neoadjuvant chemotherapy were not significantly difference (P>0.05).Ki-67 high expression was significantly decreased in 54 cases (60.0%) after treatment compared with 83 cases (92.2%) before treatment,and the difference was statistically significant (χ2=25.697,P＜0.001).ER status (χ2=16.130,P=0.000),PR status (χ2=18.881,P=0.000),Her-2 status (χ2=25.414,P=0.000),molecular classification (χ2=17.365,P=0.001) were correlated with the pCR effect of neoadjuvant chemotherapy.Multivariate regression analysis showed negative ER (P=0.023,OR=0.141,95%CI=0.026~0.760) and positive Her-2 (P=0.000,OR=10.674,95%CI=2.911~39.138) after adjusting for other variables can be used as predictors of pCR effect of neoadjuvant chemotherapy.Conclusion:NAC in breast cancer can reduce the expression level of Ki-67,and negative ER and positive Her-2 are related to pathological remission of breast cancer NAC,which has a certain guiding role in judging the prognosis of NAC.

References:

［1］BURSTEIN HJ,CURIGLIANO G,THURLIMANN B,et al.Customizing local and systemic therapies for women with early breast cancer:the St.Gallen International Consensus Guidelines for treatment of early breast cancer 2021［J］.Annals of Oncology，2021,32(10):1216-1235.
［2］胡芸,王翔,杨帆,等.MRI多模态成像在炎性乳腺癌早期诊断和新辅助化疗效果评估中的价值［J］.中华普通外科杂志,2021,36(4):295-300. HU Y,WANG X,YANG F,et al.Value of MRI multimodal imaging in early diagnosis of inflammatory breast cancer and evaluation of neoadjuvant chemotherapy ［J］.Chinese Journal of General Surgery,2021,36(4):295-300.
［3］ 黄佳旭,黄锴源,孙何兴,等.三阴性乳腺癌新辅助化疗疗效预测研究进展［J］.解放军医学杂志,2023,48(6):729-734. HUANG JX,HUANG KY,SUN HX,et al.Research progress on efficacy prediction of neoadjuvant chemotherapy for triple-negative breast cancer ［J］.Chinese Journal of Medicine,2023,48(6):729-734.
［4］ AN Junsha,PENG Cheng,TANG Hailin,et al.New advances in the research of resistance to neoadjuvant chemotherapy in breast cancer［J］.International Journal of Molecular Sciences,2021,22(17):9644.
［5］ 乳腺癌新辅助治疗的病理诊断专家共识（2020版）》编写组.乳腺癌新辅助治疗的病理诊断专家共识（2020版）［J］.中华病理学杂志,2020,49(4):296-304. Expert Consensus on Pathological diagnosis of Neoadjuvant Therapy for Breast Cancer (2020 edition).Expert consensus on pathological diagnosis of neoadjuvant therapy for breast cancer (2020 edition) ［J］.Chinese Journal of Pathology,2020,49(4):296-304.
［6］ GIULIANO ARMANDO E,EDGE STEPHEN B,HORTOBAGYI GABRIEL N.Eighth edition of the AJCC cancer staging manual:breast cancer［J］.Annals of Surgical Oncology,2018,25(7):1783-1785.
［7］ SHINTIA C,ENDANG H,DIANI K.Assessment of pathological response to neoadjuvant chemotherapy in locally advanced breast cancer using the Miller-Payne system and TUNEL［J］.Malays J Pathol，2016,38(1):25-32.
［8］ CURIGLIANO G,BURSTEIN HJ,WINER EP,et al.De-escalating and escalating treatments for early-stage breast cancer:the St.Gallen International Expert Consensus Conference on the Primary Therapy of Early Breast Cancer 2017［J］.Annals of Oncology，2017,28(8):1700-1712.
［9］ HASHMI AA,BUKHARI U,NAJAM J,et al.Luminal B,human epidermal growth factor receptor 2 (HER2/neu),and triple-negative breast cancers associated with a better chemotherapy response than Luminal A breast cancers in postneoadjuvant settings［J］.Cureus，2023,15(6):e40066.
［10］ CANDAS G,GARCIA A,OCAMPO MD,et al.Impact of immunohistochemical profile changes following neoadjuvant therapy in the treatment of breast cancer［J］.Ecancermedicalscience，2021,5(15):1162.
［11］ DEMICHELE ANGELA,YEE DOUGLAS,ESSERMAN LAURA.Mechanisms of resistance to neoadjuvant chemotherapy in breast cancer［J］.The New England Journal of medicine,2017,377(23):2287-2289.
［12］ BEAR HD,ANDERSON S,SMITH RE,et al.Sequential preoperative or postoperative docetaxel added to preoperative doxorubicin plus cyclophosphamide for operable breast cancer:National Surgical Adjuvant Breast and Bowel Project Protocol B-27［J］.Journal of Clinical Oncology,2006,24(13):2019-2027.
［13］ VAN DER HAGE JA,VAN DE VELDE CJ,JULIEN JP，et al.Preoperative chemotherapy in primary operable breast cancer:results from the European Organization for Research and Treatment of Cancer trial 10902［J］.J Clin Oncol，2001,19(22):4224-4237.
［14］ NIIKURA N,TOMOTAKI A,MIYATA H，et al.Changes in tumor expression of HER2 and hormone receptors status after neoadjuvant chemotherapy in 21 755 patients from the Japanese breast cancer registry［J］.Ann Oncol，2016,27(3):480-487.
［15］ 贾巍,张红真,王文娟,等.新辅助化疗前后乳腺癌免疫组化表达变化的研究分析［J］.浙江医学,2016,38(14):1181-1183,1187. JIA W,ZHANG HZ,WANG WJ,et al.Study on the changes of immunohistochemical expression in breast cancer before and after neoadjuvant chemotherapy ［J］.Zhejiang Med,2016,38(14):1181-1183,1187.
［16］沈方媛,曾斌,吴慧,等.新辅助化疗对不同分子亚型乳腺癌免疫标记表达的影响［J］.暨南大学学报（自然科学与医学版）,2018,39(3):229-235. SHEN FY,ZENG B,WU H,et al.Effect of neoadjuvant chemotherapy on immunomarker expression of different molecular subtypes of breast cancer ［J］.Journal of Jinan University (Natural Science & Medicine),2018,39(3):229-235.
［17］ 张毅,闫国诚,王建军.乳腺癌新辅助化疗对癌组织ER、PR、HER-2及Ki-67水平的影响［J］.临床和实验医学杂志,2019,18(8):839-842. ZHANG Y,YAN GC,WANG JJ.Effects of neoadjuvant chemotherapy on ER,PR,HER-2 and Ki-67 levels in breast cancer tissue ［J］.Journal of Clinical and Experimental Medicine,2019,18(8):839-842.
［18］ REY-VARGAS LAURA,MEJIA-HENAO JUAN CARLOS,SANABRIA-SALAS MARIA CAROLINA,et al.Effect of neoadjuvant therapy on breast cancer biomarker profile［J］.BMC Cancer,2020,20(1):675.
［19］ SHAO Z,PANG D,YANG H，et al.Efficacy,safety,and tolerability of pertuzumab,trastuzumab,and docetaxel for patients with early or locally advanced ERBB2-positive breast cancer in Asia:The PEONY phase 3 randomized clinical trial［J］.JAMA Oncol，2020,6(3):e193692.
［20］ 孙苗苗,蒋燕妮,宋国新,等.乳腺癌新辅助化疗前后免疫标志物表达变化及预后［J］.中华病理学杂志,2021,50(5):482-487. SUN MM,JIANG YN,SONG GX,et al.Expression of immune markers and prognosis of breast cancer before and after neoadjuvant chemotherapy ［J］.Chinese Journal of Pathology,2021,50(5):482-487.
［21］ WANG R,LUO D,MA X，et al.Antisense Ki-67 cDNA transfection reverses the tumorigenicity and induces apoptosis in human breast cancer cells［J］.Cancer Invest，2008,26(8):830-835.
［22］ PEROU CM,JEFFREY SS,VAN DE-RIJN-M,et al.Distinctive gene expression patterns in human mammary epithelial cells and breast cancers［J］.Proceedings of the National Academy of Sciences of the United States of America,1999,96(16):9212-9217.
［23］ ILGUN S,SARSENOV D,ERDOGAN Z，et al.Receptor discordance rate and its effects on survival in primary and recurrent breast cancer patients［J］.J BUON，2016,21(6):1425-1432.
［24］ GE Wenkai,YANG Ben,ZUO Wenshu,et al.Evaluation of hormone receptor,human epidermal growth factor receptor-2 and Ki-67 with core needle biopsy and neoadjuvant chemotherapy effects in breast cancer patients［J］.Thoracic Cancer,2015,6(1):64-69.
［25］ SASANPOUR P,SANDOUGHDARAN S,MOSAVI-JARRAHI A，et al.Redictors of pathological complete response to neoadjuvant chemotherapy in Iranian breast cancer patients［J］.Asian Pac J Cancer Prev，2018,19(9):2423-2427.
［26］ KING TARI A,MORROW MONICA.Surgical issues in patients with breast cancer receiving neoadjuvant chemotherapy［J］.Nature Reviews Clinical Oncology,2015,12(6):335-343.
［27］ BUZATTO IP,RIBEIRO-SILVA A,ANDRADE JM，et al.Neoadjuvant chemotherapy with trastuzumab in HER2-positive breast cancer:pathologic complete response rate,predictive and prognostic factors［J］.Braz J Med Biol Res,2017,50(2):e5674.
［28］ 王敬华,郑美珠,李永清.乳腺癌免疫组化分子分型与新辅助化疗疗效相关性分析［J］.中华肿瘤防治杂志,2018,25(10):704-708. WANG JH,ZHENG MZ,LI YQ.Analysis of correlation between immunohistochemical molecular typing of breast cancer and efficacy of neoadjuvant chemotherapy ［J］.Chinese Journal of Cancer Prevention and Treatment,2018,25(10):704-708.
［29］石阳,李琦,李蓉,等.局部进展期乳腺癌新辅助化疗前后生物标志物表达变化与疗效的相关性［J］.现代肿瘤医学,2016,24(01):59-63. SHI Y,LI Q,LI R,et al.Correlation between biomarker expression and therapeutic effect of neoadjuvant chemotherapy in locally advanced breast cancer ［J］.Modern Oncology,2016,24(01):59-63.
［30］ HAQUE WAQAR,VERMA VIVEK,HATCH SANDRA,et al.Response rates and pathologic complete response by breast cancer molecular subtype following neoadjuvant chemotherapy［J］.Breast Cancer Research and Treatment,2018,170(3):559-567.
［31］ 李诚,张亚囡,张雅婷,等.乳腺癌新辅助化疗Miller/Payne分级病理疗效相关预测因子分析［J］.潍坊医学院学报,2020,42(3):218-221. LI C,ZHANG YN,ZHANG YT,et al.Analysis of factors related to pathological effect of neoadjuvant chemotherapy for breast cancer ［J］.Journal of Weifang Medical College,2020,42(3):218-221.
［32］ HOUSSAMI N,MACASKILL P,VONMINCKWITZ G,et al.Meta-analysis of the association of breast cancer subtype and pathologic complete response to neoadjuvant chemotherapy［J］.European Journal of Cancer，2012,48(18):3342-3354.
［33］ LI XIAOXIAN BILL,KRISHNAMURTI UMA,BHATTARAI SHR ISTI,et al.Biomarkers predicting pathologic complete response to neoadjuvant chemotherapy in breast cancer［J］.American Journal of Clinical Pathology,2016,145(6):871-878.
［34］ 陈圣,黄焰,王也,等.新辅助化疗对浸润性乳腺癌分子标志物及分子分型的影响［J］.中华损伤与修复杂志（电子版）,2017,12(2):113-117. CHEN S,HUANG Y,WANG Y,et al.Effects of neoadjuvant chemotherapy on molecular markers and molecular typing of invasive breast cancer ［J］.Chinese Journal of Injury and Repair (electronic edition),2017,12(2):113-117.
［35］闫丰,杜华,朱红成,等.乳腺浸润性导管癌新辅助化疗的效果及组织中雌激素受体、孕激素受体、人表皮生长因子受体2和Ki-67的变化［J］.中国综合临床,2022,38(1):11-18. YAN F,DU H,ZHU HC,et al.Effect of neoadjuvant chemotherapy and changes of estrogen receptor,progesterone receptor,human epidermal growth factor receptor 2 and Ki-67 in breast invasive ductal carcinoma ［J］.Chinese Journal of General Clinic,2022,38(1):11-18.

Memo

Memo:
-
Last Update: 1900-01-01