乳癌新辅助化疗后MCM5、Ki-67和C-erbB-2表达变化及意义

EXPRESSION OF MCM5,Ki-67,AND C-erbB-2 AFTER NEOADJUVANT CHEMOTHERAPY OF BREAST CANCER AND ITS SIGNIFICANCE

目的观察人乳癌新辅助化疗前后MCM5、Ki-67和C-erbB-2蛋白的表达情况,探讨其与化疗效果的关系。方法采用免疫组化法检测新辅助化疗前后40例乳癌标本中MCM5、Ki-67和C-erbB-2的表达。结果新辅助化疗有效率为77.5%。化疗前MCM5和Ki-67蛋白阳性表达显著高于化疗后(Z=-3.94、-3.04,P<0.01),而化疗前后C-erbB-2蛋白阳性表达差异无显著性(Z=-1.60,P>0.05);化疗前MCM5蛋白阳性表达显著高于Ki-67(Z=-4.02,P<0.01)。化疗有效组(31例)MCM5蛋白阳性表达显著高于化疗无效组(9例)(Z=-3.57,P<0.01),而C-erbB-2蛋白阳性表达显著低于化疗无效组(Z=-3.92,P<0.01)。结论ET方案新辅助化疗有较好的疗效,可能通过抑制MCM5、Ki-67蛋白的表达来阻止乳癌细胞的增殖。MCM5高表达、C-erbB-2阴性者化疗更为敏感,二者可作为临床指导乳癌化疗的分子生物学指标。

Objective To study the expressions of MCM5, Ki-67, and C-erbB-2 before and after neoadjuvant chemotherapy （NC） in breast cancer patients, analyze their relationship with response to NC. Methods The expressions of MCM5, Ki-67, and C-erbB-2 before and after NC were examined hy immunohistochemistry in 40 patients with breast cancer. Results The ore-rail response rate to NC was 77.5 %. The positive expression of MCM5 and Ki-67 before the therapy was significantly higher than that after （Z=-3.94, -3.04;P〈0.01）, while there was no significant difference in the expression of C-erbB-2 between before and after chemotherapy （Z=- 1.60, P〈0.05）. Before the chemotherapy, the positive expression of MCM5 was significantly higher than that of Ki-67 （Z=-4.02,P〈0.01）. The positive MCM5 in the chemotherapy-effective group （31 cases） was higher than that of the chemotherapy uneffective （9 cases） （Z=-3.57,P〈0.01）, and the positive expression of C-erbB-2 was significantly lower （Z=- 3. 92, P〈0.01）. Conclusion Neoadjuvant chemotherapy with ET regimen is effective for breast cancer, which inhibits the proliferatation of cancer cells by restraining the expression of MCM5 and Ki 57. Patients with high expression of MCM5 and negative C-erbB 2 are more likely to respond to the therapy. Both MCM5 and C-erbB-2 can be used as molecular biological markers to guide chemotherapy for breast cancer.