ÖZ
Amaç
Bu çalışmanın amacı, hormon reseptörü pozitif (HR+)/insan epidermal büyüme faktörü reseptörü 2 (HER2) HER2- meme kanseri olan hastalarda neoadjuvan kemoterapi (NACT) sonrası patolojik tam yanıtı (pCR) öngörebilen klinik, patolojik ve enflamatuvar belirteçleri değerlendirmektir.
Gereç ve Yöntem
1 Ocak 2020 ile 1 Mayıs 2025 tarihleri arasında Sağlık Bilimleri Üniversitesi, Balıkesir Atatürk Şehir Hastanesi’nde NACT uygulanan 18-80 yaş arası HR+/HER2- meme kanseri olan 109 hasta üzerinde retrospektif bir analiz yürütülmüştür. Tüm hastalar standart antrasiklin-taksan bazlı kemoterapi almıştır. Tedavi öncesi kan testleri kullanılarak nötrofil-lenfosit oranı (NLR), trombosit-lenfosit oranı (PLR) ve sistemik immün-enflamasyon indeksi (SII) hesaplanmıştır. pCR, meme ve aksiller lenf düğümlerinde rezidüel invaziv tümör bulunmaması olarak tanımlanmıştır. pCR’yi etkileyen faktörler lojistik regresyon analizi kullanılarak değerlendirilmiştir.
Bulgular
Hastaların %21,1’inde pCR elde edildi. pCR grubunun çoğu 50 yaşın altındaydı ve luminal B alt tipine sahipti. ROC analizi, NLR, PLR ve SII’nin pCR’nin anlamlı öngörücüleri olmadığını gösterdi (p>0,05). Tek değişkenli analizde, luminal B alt tipi, düşük östrojen reseptörü (ER) seviyeleri, yüksek Ki-67 ve yüksek tümör derecesi pCR ile anlamlı şekilde ilişkiliydi. Çok değişkenli analizde, yalnızca düşük ER seviyeleri ve yüksek Ki-67 bağımsız öngörücüler olarak kaldı.
Sonuç
Enflamatuvar belirteçler, HR+/HER2- meme kanserinde pCR’yi öngörmede yetersizdir. Düşük ER seviyeleri ve yüksek Ki-67, NACT daha iyi yanıtla ilişkilidir. Bulgular, tedavi yanıtının kişiselleştirilmesinde biyobelirteçlerin önemini vurgulamaktadır.
Anahtar Kelimeler:
Meme kanseri, neoadjuvan kemoterapi, patolojik tam yanıt, enflamatuvar belirteçler, Ki-67, östrojen reseptörü
Kaynaklar
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