| 摘要 |
Objective: Neoadjuvant chemotherapy (NAC) is the mainstream treatment for
locally advanced breast cancer, and the effects of NAC have been widely discussed in
terms of morphology and biomarkers. In this study we quantify the changes in biomarkers
and analyze the morphological changes after NAC.
Methods: Paired histological tumor samples before and after NAC were obtained
from 17 breast cancer patients diagnosed as invasive ductal carcinoma by core needle
biopsy or incision biopsy at Kaohsiung Veterans General Hospital between 2001 and
2003. One patient who died of breast cancer was excluded. The remaining 16 cases
received 2-6 cycles of chemotherapy with regimens of 5FU, epirubicin and cyclophosphamide
(FEC). The effects of NAC on 13 morphometries and the expression of biomarkers
(ER, PR, p53 and Her-2/neu) were analyzed. Tumor size was evaluated by
both high spatial resolution MRI (HSR-MRI) and histomorphology change, which
were used to survey the response to NAC.
Results: In all the 17 cases, the most prominent histological features included thickening
of the basement membrane and nuclear atypia. In multivariate analysis, NAC
showed a dependent role for expression of Her-2/neu (p=0.033), but an independent
role for ER, PR and p53. Age also played an independent role. Further more, proportion
of necrosis, fibrosis and tumor size present in HSR-MRI all had good correlations
with changes in histomorphology (p < 0.05).
Conclusion: According to the results of our study and the previous literature, biomarkers
of breast cancer may change with time, and repeating a study of biomarkers
may be necessary for clinicians to decide what regimens will be most effective in the
next course of chemotherapy. |
