乳腺癌新辅助化疗疗效与ER、PR、p53及HER2表达的关系

The Relationship between the Chemotherapeutic Effect of NTC and the Expressions of ER, PR, P53 and HER2

目的回顾性分析乳腺癌新辅助化疗疗效与化疗方案及与ER、PR、p53及HER2表达情况的关系,探讨ER、PR、p53及HER2在新辅助化疗方案选择中的预测性作用。方法化疗前穿刺病理活检以明确诊断并行ER、PR、p53及HER2免疫组化检测。化疗采用CAF或CAT方案,经3～5个疗程化疗后行乳腺癌改良根治术或保乳手术,再次做病理检查及免疫组化检测,比较CAF、CAT两组间疗效差异;CAF、CAT两组内又按照有无疗效再分为有效组与无效组,分别比较有效组与无效组间ER、PR、p53及HER2表达情况的差异。结果 CAF、CAT方案对浸润性小叶癌、黏液腺癌均无明显疗效。浸润性导管癌CAT组化疗有效率为39.5%(17/43),CAF组化疗有效率为40%(14/35)。CAT方案无效组ER、PR的表达强于有效组,两组间有显著差异(P<0.05);而p53、HER2的表达强度两组间无显著差异。CAF方案有效组P53的表达强于无效组,PR的表达弱于无效组,两组间有显著差异(P<0.05);而ER、HER2的表达强度两组间无显著差异。结论 CAT与CAF方案之间疗效没有显著性差异。CAT方案对ER、PR弱表达的浸润性导管癌较敏感。CAF方案则对PR弱表达、p53强表达的浸润性导管癌较敏感。HER2表达对CAT及CAF方案疗效均没有显著性影响。

Objective To analyze the relationship between the effect of neoadjuvant chemotherapy（NCT） of the breast cancer and the expressions of ER,PR,P53 and HER2,explore the predictive actions of ER,PR,P53 and HER2 in NCT.Methods NCT adopts CAF or CAT schemes.Immunochemistry was performmed to detect the expressions of ER,PR,P53 and HER2 in effective group and invalid group that had endured 3-5 courses of CAT or CAF NCT.Results The expressions of ER,PR were stronger in invalid group than in effective group,but the expression of HER2 in two groups have no marked difference.Conclusion The effects of NCT have no marked difference in CAT and CAF scheme group.CAT/CAF schemes are more sensitive in incasive ductal cancer that ER,PR express weakly,CAF scheme is more sensitive in cases that P53 expresses strongly,but the expressions of HER2 have no marked affect on the effects of CAT/CAF.