中文摘要：

目的探讨在新辅助化疗（NAC）前后乳腺癌组织中雌激素受体（ER）、孕激素受体（PR）、人表皮生长因子受体（HER-2）表达的变化及与临床疗效之间的关系。方法采用多中心、回顾性研究，收集三家医院自2015年1月～2017年1月行NAC的乳腺癌患者360例，新辅助化疗前穿刺取病变部位组织活检和手术时取癌组织标本，采用免疫组化方法检测乳腺癌组织中ER、PR、HER-2表达的变化，比较化疗前后分子标记物变化与临床病理特征及新辅助化疗疗效间的关系。结暴新辅助化疗临床有效率为84．2％，其中CR为9．7％、PR为74．4％。年龄、淋巴结状态、ER状态、Her-2表达与新辅助化疗疗效无明显关系（P〉0．05），而肿瘤大小、PR状态与新辅助化疗疗效具有一定关系（P〈0．05），肿瘤越大，PR阴性患者，新辅助化疗效果较好；新辅助化疗后，部分乳腺癌组织中的ER表达发生改变（P〈0．05），但PR及Her-2表达无明显变化（P〉0．05）。结论乳腺癌病灶大小、PR状态与新辅助化疗疗效可能有关，新辅助化疗可使部分乳腺癌组织中的ER表达发生改变，但对PR及Her-2表达无明显影响。

英文摘要：

Objective To investigate the changes of the expression of estrogen receptor （ER）, progesterone receptor （PR） and human epidermal growth factor receptor （HER2） in breast cancer before and after neoadjuvant chemotherapy. Methods The multi-center, retrospective study was adopted. A total of 360 patients with breast cancer who accepted neoadjuvant chemo- therapy from January 2015 to January 2017 were enrolled. The expressions of ER, PR and Her2 protein in cancer tissues before neoadjuvant chemotherapy and after operation were detected by using immunohistochemitry. The correlation between the changes of molecular marker expression, clinical pathological features and the NAC therapeutic effect was studied. Results The total clinical effective rate （RR） was 84. 2%, of which the complete response （CR） rate was 9.7%, and the partial response （PR） rate was 74.4%. There was no significant correla- tion of age, lymph node status and the expression of ER, HER2 protein with the NAC thera- peutic effect （P 〉 0.05 ）, while the therapeutic effect was correlated with tumor size, PR status （P 〈 0. 05 ）. Patients with bigger tumor size and negative PR expression had better therapeutic effect. The expression of ER was changed by neoadjuvant chemotherapy significantly （P 〈 0.05 ）, while the expression of PR and HER2 were not changed （ P 〉 0. 05 ）. Conclusion The tumor size and PR status of breast cancer may have correlation with the therapeutic effect of NAC. NAC has effect on the expression of ER, but no effects on the expression of PR and Her- 2 protein.