ET方案新辅助化疗对乳腺癌组织中CXCR4表达的影响及临床意义

Effect of Paclitaxel in Combination with Epirubicin Neoadjuvant Chemotherapy on Expression of CXCR4 in Breast Cancer and its Clinical Significance

目的探讨ET方案新辅助化疗对乳腺癌组织中CXCR4表达的影响及临床意义。方法回顾性分析我院2005年4月至2009年3月期间59例接受3周期ET(紫杉醇+表阿霉素)方案新辅助化疗的Ⅱ期、Ⅲ期乳腺癌患者的临床资料,应用免疫组化方法检测乳腺癌组织中CXCR4的表达情况,分析其与临床病理特征的关系。结果 CXCR4在乳腺癌组织中的表达阳性率为94.9%(56/59),在癌旁正常组织中不表达。CXCR4表达水平与淋巴结转移(P=0.019)及肿瘤TNM分期有关(P=0.040),与患者年龄、肿瘤大小、组织学分级、ER和PR状态以及HER2表型无关(P>0.05)。新辅助化疗后CXCR4表达水平下降,但CXCR4的表达水平及化疗后下降的比例与化疗疗效无关(P>0.05)。CXCR4的表达分布状态中呈簇状分布者化疗疗效好于呈散在分布者(P=0.015)。结论 ET方案新辅助化疗后乳腺癌组织中CXCR4的表达水平下降比例与化疗疗效无关,但其表达的分布状态可作为新辅助化疗疗效的参考指标。

Objective To evaluate the effect of neoadjuvant chemotherapy on the expression of CXCR4 in breast cancer and its clinical significance. Methods The clinical data of 59 patients with breast cancer of stage Ⅱ and stage Ⅲ underwent neoadjuvant chemotherapy with paclitaxel plus epirubicin for 3 cycles between April 2005 and March 2009 were retrospectively analyzed. The expression of CXCR4 in the breast cancer tissues before and after neo-adjuvant chemotherapy was examined by immunohistochemistry and its relationship with clinicopathologic factors was analyzed.Results The CXCR4 positive expression was observed in 56 patients with breast cancer （94.9%）,but not in corresponding non-tumor normal tissues. The expression level of CXCR4 was correlated to lymph nodes metastasis （P=0.019） and breast cancer stage （P=0.040）,but it was not correlated to age of patients,tumor size,grade,hormone receptor （ER and PR）,and HER2 status. The expression level of CXCR4 was significantly decreased after neoadjuvant chemotherapy. Decline extent of CXCR4 expression after chemotherapy and CXCR4 expression level were not correlated to the effect of neoadjuvant chemotherapy,while the effect of chemotherapy in patients expressed CXCR4 in cluster distribution was better than that in scattering distribution （P=0.015）. Conclusion The decline extent of CXCR4 expression level after paclitaxel combined with epirubicin neo-adjuvant chemotherapy is not correlated to the efficacy,but its expressing distribution may be considered as an index to the effect of neoadjuvant chemotherapy.