Predictive Significance of p53, Ki-67, and Bcl-2 Expression for Pathologic Complete Response after Neoadjuvant Chemotherapy for Triple-Negative Breast Cancer

다국어 초록 (Multilingual Abstract)

Purpose: Patients with triple-negative breast cancer (TNBC) withpathologic complete response (pCR) to neoadjuvant chemotherapy(NAC) have superior survival outcomes compared to thosewith residual disease after NAC. This study investigated the valueof three biomarkers, p53, Ki-67, and Bcl-2 for predicting pCRin NAC-treated patients with TNBC. Methods: Between 2003and 2012, 198 patients with pathologically confirmed primaryTNBC were treated with two different taxane-based chemotherapeuticregimens prior to surgery. Before NAC, expression ofp53 (cutoff 25%), Ki-67 (cutoff 10%), and Bcl-2 (cutoff 10%) wasassessed immunohistochemically in core biopsy specimens.
The incidence of pCR was correlated with the expression ofthese biomarkers. Results: Overall, pCR occurred in 37 of the198 patients (18.7%). A significant association was observedbetween the pCR rate and overexpression of the p53 and Ki-67biomarkers. Multivariate analysis showed that only p53 expressionwas independently associated with pCR to NAC (odds ratio,3.961; p=0.003). The sensitivity, specificity, positive predictivevalue, and negative predictive value of p53 expression for predictingpCR were 77.8%, 50.3%, 26.2%, and 90.9%, respectively.
The pCR rate was the lowest (5.2%) in patients with lowexpression of both p53 and Ki-67, and it was the highest (25.8%)when both biomarkers showed high expression. Conclusion: Expressionof p53 was significantly associated with pCR after NACin patients with TNBC, suggesting that this biomarker might beparticularly valuable in identifying TNBC patients prone to haveresidual disease after NAC.

참고문헌 (Reference)

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