乳腺癌新辅助化疗后细胞增殖与凋亡的变化及临床意义

Changes of apoptosis and proliferation of breast cancer after neoadjuvant chemotherapy and their clinical significance

目的:观察乳腺癌患者新辅助化疗前后细胞增殖及凋亡的变化,分析与化疗疗效的关系。方法:51例乳腺癌患者术前经Mammotome穿刺活检确诊,在CEF方案新辅助化疗前及化疗2个周期后分别进行癌组织中Ki-67的免疫组织化学染色和TUNEL原位细胞凋亡检测,并评价化疗疗效。结果:新辅助化疗前Ki-67阳性表达率及凋亡指数(AI)分别为23.2%和34.1%,化疗2个周期后Ki-67阳性表达率及AI分别为7.8%和67.5%,两者差异有统计学意义,P=0.004,P=0.006;化疗疗效临床CR5例,PR40例,SD6例,无疾病进展期病例,新辅助化疗疗效与Ki-67表达下降及肿瘤细胞凋亡增加显著相关。结论:新辅助化疗可明显抑制乳腺癌细胞的增殖,诱导凋亡,与化疗疗效密切相关。

OBJECTIVE： To observe the changes of apoptosis and proliferation of breast cancer after neoadjuvant chemotherapy and discuss the relationship with chemotherapy. METHODS： Fifty-one cases of breast cancer were diagnosed by Mammotome. Expressions of Ki 67 and AI were detected by immunohistochemistry and TUNEL respectively before and after 2 cycles of chemotherapy. The effectiveness of chemotherapy was also observed after the chemotherapy. RESULTS： Before neoadjuvant chemotherapy, the expression rates of Ki-67 and AI were 23. 2% and 34. 1%, respectively. There was a statistic significance compared with the expression levels of Ki-67 and AI after the chemotherapy （7. 8%- 67. 5% ）, P=0.004 ＆ P= 0. 006. The complete response and partial response were achieved in 5 patients and 40 patients, respectively. There were no disease progressed （PD） cases. The expressions of Ki-67 and AI were closely related to patients＇ response to neoadjuvant chemotherapy. CONCLUSION： Neoadjuvant chemotherapy can inhibit the proliferation of breast cancer cell and induce apoptosis, which are closely related to the effectiveness of chemotherapy.