TOPOⅡ和P53与乳腺癌新辅助化疗疗效的关系研究

Levels of TOPO Ⅱ and P53 predict the efficacy of neoadjuvant chemotherapy in breast cancer

目的本研究旨在检测化疗前乳腺癌组织中TOPOⅡ和P53的表达情况,探讨二者与新辅助化疗疗效之间的关系。方法本研究回顾性分析了我院乳腺肿瘤医学部自2011年10月至2015年8月接受以蒽环类为基础新辅助化疗的Ⅱ~Ⅲ期浸润性导管癌患者185例,化疗前用空心针穿刺活检,按常规免疫组化的方法检测TOPOⅡ、P53的表达情况。统计学分析TOPOⅡ、P53的表达水平与患者临床病理特征及与新辅助化疗效果的关系。结果TOPOⅡ阳性的患者中达到客观缓解的较表达阴性比例更大（P=0.002）,P53阳性的患者中达到临床完全缓解的比例比阴性患者更大（P=0.015）,TOPOII及P53均为阳性的患者达到临床完全缓解及客观缓解的比例均较高（P=0.010及P=0.027）。结论新辅助化疗前乳腺癌组织中TOPOⅡ和P53的表达水平对新辅助化疗有良好的预测效果。

Objective To investigate whether the expression of TOPO Ⅱ and P53 expression in breast cancer could predict the efficacy of neoadjuvant chemotherapy. Methods This research retrospectively analyzed 185 patients, who were diagnosed as invasive ductal carcinomas in stage Ⅱ-Ⅲ, admitted in the Breast Cancer Center in our hospital and accepted NAC from October 2011 to August 2015. Immunohistochemical assay was used to detect the TOPO Ⅱ and P53 protein levels of185 breast cancer tissues obtained by core needle biopsy before neoadjuvant chemotherapy. The relationship of TOPO Ⅱ and P53 expression with clinicopathological characteristics as well as prognosis of neoadjuvant chemotherapy was statistically analyzed. Results The objective response rate（ORR）of patients with positive TOPO Ⅱ expression was significantly higher than that of patients with negative TOPO Ⅱ expression. The clinical complete response（c CR） proportion of patients with positive P53 expression was larger than that of patients with negative P53 expression. The patients with both positive TOPO Ⅱ and P53 expression not only achieved a higher rate of ORR but had a larger proportion of c CR than the case in patients not with both positive TOPO Ⅱ and P53 expression.Conclusion The protein levels of TOPO Ⅱ and P53 showed predictive value of the efficacy of neoadjuvant chemotherapy based on anthracyclines.