mTOR表达与雌激素受体阳性乳腺癌辅助内分泌治疗预后的关系

Correlation between mTOR expression and adjuvant endocrine therapy in ER-positive breast cancer

目的探讨雌激素受体(estrogen receptor,ER)阳性乳腺癌中mTOR蛋白的表达与乳腺癌辅助内分泌治疗预后间的关系。方法采用免疫组化方法检测60例ER阳性且接受内分泌辅助治疗患者的原发乳腺癌组织中p-mTOR蛋白的表达情况,观察mTOR蛋白的表达特点.并分析其与临床特征间的关系及对无病生存的影响。结果 mTOR蛋白强阳性表达的乳腺癌细胞具有更多的组织学恶性特征,mTOR阴性组中位无病生存(56.4个月)显著优于阳性组(33.5个月)(P=0.015),多因素回归分析中mTOR为阳性者发生肿瘤复发转移的风险比例(HR)是mTOR阴性者的3.212倍,其95%CI为1.291～7.992。结论 mTOR表达状态为ER阳性是乳腺癌复发转移的独立预后因素,提示辅助内分泌治疗联合mTOR抑制剂可为ER阳性乳腺癌患者带来生存获益。

Objective To investigate the expression of mTOR in ER-positive breast cancer tissue, and analyze the correlation between efficacy of adjuvant endocrine treatment and tumor prognosis. Method Immunohistochemical method was applied to test mTOR expression in 60 breast cancer cases, the correlation between roTOR level and other clinicopatho- logical features was analyzed to identify survival differentiations. Result Strong positive mTOR expression cell in breast cancer showed an invasive feature. The disease free survival （DFS） in mTOR negative group was significantly longer than that in positive group （54. 1 months vs 31.9 months） （P =0. 015）. In multivariate regression analysis, tumor with posi- tive roTOR had a higher proportional hazards ratio （HR）, of which the recurrence and metastasis possibility was 3. 212 times higher that of negative roTOR, with 95% CI being 1. 291 -7. 992. Conclusion mTOR expression status is an in- dependent prognosis factor for recurrence and metastasis of breast cancer, indicating that adjuvant endocrine therapy com- bined with mTOR inhibitor can transform to survival benefit of ER positive breast cancer patients.