CEF新辅助化疗对乳腺癌MAPK/PI3K通路的影响

Effect of CEF neo-adjuvant for MAPK/PI3K signal pathway in breast cancer

目的通过检测CEF方案新辅助化疗前后乳腺癌组织中pMEK和pAKT蛋白水平的改变,分析该方案疗效与MAPK和PI3K信号通路之间的关系。方法选取Ⅱ～Ⅲ期乳腺癌患者54例,行CEF方案新辅助化疗。检测患者化疗前和手术后肿瘤标本中pMEK和pAKT蛋白的表达情况,分析该化疗方案对患者pMEK、pAKT的影响和化疗效果之间的关系。结果化疗后达到PR 42例,SD 7例,PD 5例,有效率77.78%(42/54)。pMEK及pAKT的表达与化疗效果均呈负相关(P<0.05)。化疗后pMEK及pAKT的表达水平下降(P<0.05)。结论CEF方案化疗可通过抑制MAPK和PI3K通路的关键蛋白pMEK和pAKT的表达发挥治疗作用,但对pMEK和pAKT高表达的患者疗效欠佳。检测这两条通路的关键蛋白pMEK和pAKT可能对指导乳腺癌化疗和判定疗效有一定价值。

Objective To investigate the change of CEF neo-adjuvant chemotherapy （NAC） for pMEK and pAKT change in breast cancer, the mechanism of CEF neo-adjuvant chemotherapy, and analyze the effect and the relationship between the schemes MAPK and PI3K signal pathway. Methods Total of 54 patients with breast cancer in stage Ⅱ-Ⅲ were selected. These patients were randomly treated with CEF neo-adjuvant chemotherapy. The expressions of pMEK and pAKT of tumor tissues were detected by immunohistochemistry （IHC） before and after the neo-adjuvant chemotherapy. Sta- tistical methods were utilized to analyze the relationship between the therapeutic effect of CEF neo-ad- juvant chemotherapy and the expressions of pMEK and pAKT, and the influences of CEF neo-adju- vant chemotherapy to the molecules. Results 42 patients of the group got PR, 7 patients got stable of disease （SD）, and 5 patients of the group got progressive of disease （PD）, and effective rate was 77.78% （42/54）. The expression of pMEK and pAKT were negative relationship with the therapeutic effect of CEF neo-adjuvant chemotherapy （P〈0.05）. The changes of the expression of pMEK and pAKT after treated with CEF NAC were decreased and there were differences in statistical significance （P〈0.05）. Conclusion CEF regimen has effect by inhibit the key protein which the expression of pMEK and pAKT of MAPK/PI3K pathway in the proliferation of breast cancer cells, but the therapy effect are poor to the patients expression of high level of pMEK and pAKT. There are certain valueby key protein of pMEK and pAKT pathway are detected and guide the chemical therapy and judge curative effect .