乳腺癌生物学因子与新辅助化疗疗效的相关性分析

Study of Relationship Between the Expression of Biological Markers in Cancinoma Tissue and the Efficacy of Neoadjuvant Taxanes and Anthracycline Chemotherapy in Patients with Breast Cancer

目的:评价不同生物学因素在预测紫杉醇加蒽环类方案治疗乳腺癌疗效中的作用。方法:68个接受了4个周期紫杉醇加蒽环类新辅助化疗的病人被纳入这项回顾性研究。用免疫组化法检测化疗前乳腺癌组织中ER、PR、HER-2、Bcl-2和p53的表达情况,分析生物学标记物与临床、病理完全缓解之间的关系。结果:有效率84%,其中临床完全缓解34%,临床部分缓解50%。病理完全缓解仅18%。ER、PR阴性和HER-2过表达对病理完全缓解有预测价值(P<0.05、0.05、0.05)。Bcl-2和p53与病理完全缓解之间无相关性。结论:HER-2过表达和激素受体阴性的病人对紫杉醇加蒽环类新辅助化疗可能更为敏感,可能作为预测该方案疗效的生物学标记物。

Objective To evaluate the predictive value of expression of different biological factors in cancer tissue for treatment efficacy of neoajuvant taxane and anthracycline chemotherapy in patients with breast cancer. Methods 68 patients treated with 4 cycles of neoadjuvant taxanes and anthracycline were included in this retrospective study, Immunohistochemieal studieswere performed for estrogen receptor（ ER）, progesterone receptor（ PgR）, HER- 2, Bcl -2, and p53 protein expressions in pretreatment biopsy materials. The relationship between biological marker expression and clinical as well as pathological complete remission （ cCR and PCR） rate was an - alysed. Results The overall clinical response rate was 84% , with 34% clinical complete remission （cCR） and 50% clinical partial remission. The pCR rate was only 18%. Abseenee of ER, PgR expression and overexpression of HER -2 were predictive of higher pCR （P = 0.018, 0.012, 0.010, respectively）, p53 expression did not show any association with pCR rate. Conclusion Patients with overexpression of HER - 2 and negative hormonal receptor status are much more likely to respond better to neoadjuvant taxane and anthracycline chemotherapy. With higher pCR rate. These factors might serve as predictive markers for this regimen.