血浆EGF水平对乳腺癌新辅助化疗疗效的预测价值

Predictive role of plasma EGF level for efficacy of neoadjuvant chemotherapy in patients with breast cancer

目的探讨血浆表皮生长因子(EGF)水平变化对于新辅助化疗疗效的预测价值。方法检测2015年9月20日至2016年5月31日江苏省人民医院乳腺外科空心针穿刺活检证实为浸润性导管癌的49例女性患者(乳腺癌组)新辅助化疗前后血浆EGF水平,对照组为同期入院穿刺活检证实为乳腺纤维腺瘤的36例女性患者。新辅助化疗方案为EC-T(表阿霉素75 mg/m^2静滴,环磷酰胺600 mg/m^2静滴,序贯多西他赛100 mg/m^2静滴),21天为1个周期,术前给予8周期化疗。血浆EGF检测采用ELISA法。分析两组患者血浆EGF水平差异,乳腺癌患者化疗前血浆EGF水平与临床病理特征的关系,以及新辅助化疗前后不同疗效组间EGF的变化情况。结果乳腺癌组患者血浆EGF明显高于对照组(P<0.05)。血浆EGF水平与患者年龄、淋巴结转移情况以及术前穿刺病理标本的激素受体状态、HER-2状态均无关。化疗前两组患者EGF水平相近,化疗后化疗反应4~5级组EGF水平明显低于化疗反应1~3级组(P<0.05)。化疗反应4~5级组EGF化疗后水平/化疗前水平明显低于1~3级组(P<0.05)。化疗反应性较差的患者化疗后血浆EGF水平明显上升(P<0.05),化疗反应性较好的患者化疗后血浆EGF水平明显下降(P<0.05)。结论血浆EGF可能与新辅助化疗的疗效相关,监测血浆EGF水平变化对预测乳腺癌新辅助化疗疗效有一定的作用。

Objective To explore the predictive value of the epidermal growth factor （EGF） in plasma in neoadjuvant chemotherapy （NCT） in breast cancer. Methods A total of 49 patients with breast carcinoma and 36 females with fibroadenoma from Department of Breast Surgery, the First Affiliated Hospital of Nanjing Medical University from September 20, 2015 to May 31, 2016 was included in this study. Patients with breast cancer received EC-T regimen （ epirubincin 75 mg/m2iv dl, cyclophosphamide 600 mg/m2 iv dl, and docetax- el 100 mg/m2 iv dl ） for 8 cycles with 21 days per cycle. The level of plasma EGF was detected by ELISA. The difference between patients with breast cancer and the negative control group was analyzed. The relationship be- tween clinical efficacy of NCT, clinicopathological features and plasma EGF was analyzed. Results Levels of plasma EGF were significantly increased in patients with breast cancer compared with the control group （P 〈 0. 05 ）. No significant differences were observed among age, lymph node metastasis, biopsy results and HER-2 status. The levels of plasma EGF of pre-neoadjuvant chemotherapy between different groups of chemotherapy re-sponse showed no significance. The plasma EGF level of the chemotherapy response 4 - 5 grade group decreased significantly after NCT （ P 〈 0. 05 ）. The plasma EGF level of 1 - 3 grade group increased significantly after NCT （P 〈 0. 05 ）. The plasma EGF level was significantly increased in patients with poor response to chemo- therapy （ P 〈 0. 05 ）, and significantly decreased in patients with better response to chemotherapy after NCT （ P 〈 0. 05）. Conclusions The plasma EGF level is related with the efficacy of NCT. Monitoring of the level of plasma EGF may predict the efficacy of NCT in breast cancer.