S期细胞比率对乳腺癌新辅助化疗敏感性的预测价值

Predictive value of S-phase fraction on the sensitivity of breast cancer patients to neoadjuvant chemotherapy

目的探讨乳腺癌细胞S期细胞比率(SPF)能否作为乳腺癌新辅助化疗敏感性的预测因子。方法通过流式细胞仪检测2006年1月至2010年11月贵阳医学院第一附属医院乳腺外科收治的66例乳腺癌患者新辅助化疗前后乳腺癌组织中细胞SPF的变化,并比较SPF与临床病理特征之间的关系,统计分析采用配对资料的t检验及秩和检验。结果在66例患者中,新辅助化疗疗效评价为6例病理完全缓解(pCR),41例部分缓解(PR),17例病情稳定(SD),2例疾病进展(PD)。41例PR患者的SPF新辅助化疗前为(7.69±4.67)%,新辅助化疗后为(5.58±4.61)%,差异有统计学意义(t=2.314,P=0.026)。19例化疗无效的患者(包括SD、PD)新辅助化疗前SPF为(4.52±3.30)%,新辅助化疗后SPF为(4.19±3.01)%,差异无统计学意义(t=0.50,P=0.623)。47例客观缓解的患者(包括pCR、CR、PR)新辅助化疗前的SPF为(7.26±4.53)%,与19例化疗无效的患者新辅助化疗前的SPF[(4.52±3.30)%]比较,差异有统计学意义(t=2.394,P=0.020)。新辅助化疗前癌灶的SPF与患者年龄、月经状况无明显关系(Z=-1.461,-1.097;P>0.05),而与肿瘤直径、临床分期、淋巴结转移有关(χ2=8.258,11.920;Z=-2.194;P<0.05)。结论新辅助化疗对乳腺癌细胞S期的影响是明显的,可以降低乳腺癌细胞的增殖,SPF值较大者对化疗敏感。

Objective To evaluate whether S-phase fraction（SPF） can be used as a sensitive predictor for neoadjuvant chemotherapy in breast cancer patients.Methods The SPF change of breast cancer tissues from 66 breast cancer patients treated in Department of Breast Surgery,the First Affiliated Hospital of Guiyang Medical College,between January 2006 and November 2010 was detected by flow cytometry before and after neoadjuvant chemotherapy.Paired t test was used to analyze the change of SPF,and rank sum test was used to determine the relationship between SPF and clinical pathological characteristics.Results In all 66 cases,after neoadjuvant chemotherapy,there were 6 cases evaluated with complete pathologic response （pCR）,41 with partial response （PR）,17 with stable disease （SD） and 2 with progressive disease （PD）.In 41 patients with PR,SPF was （7.69±4.67） ％ before chemotherapy,（5.58±4.61） ％ after chemotherapy,respectively,and the difference was statistically significant （t =2.314,P =0.026）.In 19 patients with PD plus SD,SPF was （4.52±3.30）％ before chemotherapy,（4.19±3.01）％ after chemotherapy,respectively,which indicated no statistically significant difference （t =2.314,P =0.026）.SPF in the 47 patients with remission （including pCR,CR,PR） was （4.52±3.30）％ before chemotherapy,which was statistically different from that in the 19 patients with PD plus SD before chemotherapy [（4.19±3.01） ％] （t =2.314,P =0.026）.SPF of breast cancer tissue before neoadjuvant chemotherapy was related with tumor diameter,clinical stage and lymph node metastasis（F =8.258,11.920 ; Z =-2.194 ; P ＜ 0.05）,but with no correlation with patients ＇ age and menstruation status （Z =-1.461,-1.097 ; P ＞ 0.05）.Conclusion The neoadjuvant chemotherapy has a remarkable influence on S phase of breast cancer cells and it can decrease cell proliferation,implicating that the patients with higher SPF may be more sensitive to chemotherapy.