密集化疗对乳腺癌术后患者调节性T细胞及AKT蛋白的影响

Impact of intensive chemotherapy on levels of regulatory T cells and protein AKT in patients with breast cancer after surgery

目的探讨密集化疗方案对乳腺癌患者调节性T细胞及AKT蛋白含量的影响。方法收集具有术后复发高危凶素的乳腺癌患者36例并随机分为观察组及对照组各18例，前者给予表阿霉素（EPI）联合环磷酰胺（CTX）行序贯紫杉醇（PTX）的2周化疗方案，后者给予EPI联合PTX的3周化疗方案；丁化疗前及化疗结束后1周分别采集患者的外周血，采用流式细胞术检测CD4＋CD25＋调节性T细胞（Treg）的数量；使用免疫组化SP法对病灶活检进行AKT蛋白的免疫组化检测，并采用图像分析软件对AKT蛋白的含最进行定量分析。结果治疗前两组患者的Treg数量及AKT蛋白表达比较，差异均尢显著性（P〉0．05）治疗后观察组患者Treg7（降为（9．32±2．47）％，明显低于对照绢的（12．96±3．65）％，差异仃显著性（P=0．021）；治疗后观察组AKT抗原表达密度比值下降为（0．371±0．096），对照组为（0．512±0．108），组间差异具有显著性（P=0．016）相关性分析显示，Treg与AKT蛋白含量呈显著正相关性（r=0．786，P=0．013）。结论密集化疔方案较常规方案更加有效降低具有术后复发高危凶素的乳腺癌患者的Treg及AKT蛋白。

Objective To explore the effect of intensive chemotherapy on levels of regulatory T cells （Treg） and protein AKT in patienls with breast cancer. Methods 36 patients with high risk factors tier postoperative recurrence were randomly assigned to receive EPl eombined with CTX and PTX for two weeks （study group, 18 patients） or EPI plus PTX for 3 weeks. The amounts of Treg, CD4 and CD25 were detected by flow-cytometry and AKT level was determined by imnmnohistochemistry before and one week after chemotherapy. Results The baseline Treg amount and AKT level did not dilfer significantly between the two groups （P〉0.05）. After chemotherapy, the rate of Treg was significantly lower in the study group than in the control group [（9.32 ± 2.47）% vs. （2.96 ± 3.65）%, P= 0.021]; the expression ratio of AKT antigen was significantly lower in the study group than in the control group [（0.371± 0.096）vs.（0.512 ± 0.108）, P= 0.016]. Treg level was positively related with AKT level （r = 0.786, P= 0.013）. Conclusions Intensive chemotherapy is more effective than regular chemotherapy in decreasing the expressions of regulatory T cells and protein AKT in patients with breast cancer.