目的 探讨p53、ki67、nm23、表皮生长因子受体(EGFR)在局部晚期乳腺癌新辅助化疗疗效评估中的价值。 方法 选取2013年1月1日~2018年3月31日我院收治的局部晚期乳腺癌患者98例，检测新辅助化疗前后p53、ki67、nm23、EGFR的变化及其与临床疗效的关系。 结果 化疗后的p53、ki67、EGFR阳性表达均较化疗前降低，nm23阳性表达均较化疗前升高，差异均有统计学意义（P<0.05）。p53阳性者的有效率低于阴性者，差异有统计学意义（P<0.05）；ki67、nm23阳性者的有效率均高于阴性者，差异均有统计学意义（P<0.05）；EGFR阳性者与阴性者的有效率差异无统计学意义（P>0.05）。 结论 新辅助化疗能够显著改善局部晚期乳腺癌患者生物学因子p53、ki67、EGFR、nm23的表达，同时p53、ki67、nm23对评估化疗疗效具有一定价值。

To explore the value of p53, Ki67, nm23 and epidermal growth factor receptor (EGFR) in the evaluation of the efficacy of neoadjuvant chemotherapy for locally advanced breast cancer. Methods From January 1, 2013 to March 31, 2018, 98 cases of locally advanced breast cancer in our hospital were selected as the research subjects. The changes of p53, Ki67, nm23 and EGFR before and after neoadjuvant chemotherapy and their relationship with clinical efficacy were detected. Results The positive expression of p53, Ki67 and EGFR after chemotherapy were all lower than those before chemotherapy, and the positive expression of nm23 was higher than that before chemotherapy, the difference was statistically significant (P<0.05). The effective rate of p53 positive was lower than that of the negative ones, and the difference was statistically significant (P<0.05). The effective rates of Ki67 and nm23 positive were higher than that of negative ones, and the difference was statistically significant (P<0.05). There was no statistical difference in effective rate between the positive EGFR and negative ones (P>0.05). Conclusion Neoadjuvant chemotherapy can significantly improve the expression of biological factors p53, Ki67, EGFR and nm23 in locally advanced breast cancer patients, and p53, Ki67 and nm23 have certain value in evaluating the curative effect of chemotherapy.