Hubungan antara HER-2/neu dan Ki-67 dengan Respons Kemo-terapi Neoadjuvan pada Karsinoma Payudara Lanjut Lokal

Abstract

Background Locally advanced breast cancer (LABC) were stage III breast carcinoma based on TNM system, with an incidence >50% of all breast cancers in developing countries , including Indonesia. The first treatment of LABC is neoadjuvant chemotherapy, most often in anthracycline base. The purpose of this study is to analyze the relationship between HER-2/neu and Ki-67 with anthracycline-based neoadjuvant chemotherapy responsse in LABC. Methods The study involved 52 LABC, each of 26 patients responsding and not responsding. Paraffin block from biopsy stained with HER-2/neu and Ki-67 immunohistochemistry. HER-2/neu expression interpreted as positive and negative, while Ki-67 were categorized as <14% and ≥14%. Neoadjuvant chemotherapy responsse using WHO criteria were simplified to responsd and do not responsd. Results The results showed a mean age of 47.4 years (SD 11.01). Fifteen patients responsded had positive HER-2/neu expression, and only 2 of the 26 patients who did not responsd showed HER-2/neu positive. Twenty-two patients who responsded showed high cell proliferation, and conversely 20 patients who did not responsd had a Ki-67<14% (p<0.001). Combined HER-2 and Ki-67 had a pseudo R2 is higher than a single examination, with a pseudo R2 Ki-67 was higher than HER-2. This shows the combined HER-2 and Ki-67 have a higher value for predicting the anthracycline-based neoadjuvant chemotherapy responsse. These results are consistent with the theory that malignant cells with high proliferation more responssive to chemotherapy because the chemotherapy is working well on the active proliferated cells . Conclusion HER-2/neu and Ki-67 associated with response to anthracycline-based neoadjuvant chemotherapy in LABC (p<0,001). Key words: HER-2/neu, Ki-67, locally-advanced breast cancer, neoadjuvant chemotherapy.