血清E-cadherin、sE-cadherin水平与乳腺癌临床分期及疗效相关性分析

Correlation between serum E-cadherin,sE-cadherin level and chemotherapy efficacy in patients with breast cancer

目的分析乳腺癌患者血清E-钙粘蛋白(E-cadherin)、可溶性E-钙粘蛋白(sE-cadherin)水平与临床分期及化疗疗效的相关性。方法回顾性分析成都大学附属医院行多西他赛+吡柔比星+环磷酰胺(TAC)方案化疗的62例乳腺癌患者临床资料。记录患者化疗前后E-cadherin表达及sE-cadherin水平,分析其与患者病例特征的关系,并评估治疗前糖类抗原153(carbohydrate antigen 153,CA153)与E-cadherin表达及sE-cadherin水平的相关性,同时分析患者临床分期、化疗疗效与化疗前E-cadherin表达情况、sE-cadherin水平的相关性。结果乳腺癌患者E-cadherin表达情况及sE-cadherin水平在不同年龄、肿瘤直径和雌激素受体(estrogen receptor,ER)、孕激素受体((progesterone receptor,PR)、人类表皮生长因子受体-2(human epidermal growth factor receptor 2,HER-2)表达情况比较,差异无统计学意义(P>0.05);但伴淋巴结转移者E-cadherin阳性率低于无淋巴结转移者(P<0.05),而伴淋巴结转移者血清sE-cadherin水平高于无淋巴结转移者(P<0.05)。化疗后,62例乳腺癌患者E-cadherin表达较化疗前下调(P<0.05),血清sE-cadherin水平较化疗前升高(P<0.05),而CA153水平较化疗前降低(P<0.05)。不同临床分期、不同化疗疗效患者化疗前sE-cadherin水平差异显著(P<0.05);且经Pearson相关分析,发现临床分期、化疗疗效与化疗前sE-cadherin水平呈正相关(r=0.394、0.398,P<0.05)。结论化疗前E-cadherin表达强度越低、血清sE-cadherin水平越高,乳腺癌患者临床分期越高,TAC化疗效果也越好,E-cadherin与sE-cadherin可作为评估乳腺癌病情进展及预后的重要生物标志物。

Objective To analyze the correlation between serum E-cadherin, soluble E-cadherin (sE-cadherin) level and chemotherapy efficacy in patients with breast cancer. Methods Sixty two patients with breast cancer who underwent chemotherapy regimen of taxotere+pirarubicin+cyclophosphamide (TAC) were retrospectively analyzed. The E-cadherin expression and sE-cadherin level in 62 patients were recorded before and after chemotherapy, and their relationship with pathological features was analyzed. The correlation between clinical stages, chemotherapy efficacy and E-cadherin expression, sE-cadherin level before chemotherapy was analyzed. Results There were no significant differences in the E-cadherin expression and sE-cadherin level in breast cancer patients with different ages, tumor diameters and expression of estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor-2 (HER-2)( P >0.05). However, the positive rate of E-cadherin in patients with lymph node metastasis was lower than that in patients without lymph node metastasis ( P <0.05) while the serum sE-cadherin level was higher than that in patients without lymph node metastasis ( P <0.05). After chemotherapy, the expression of E-cadherin in 62 patients with breast cancer was down-regulated compared with that before treatment ( P <0.05), and the serum sE-cadherin level was increased compared with that before treatment ( P <0.05), while the CA153 level was decreased ( P <0.05). There were significant differences in the level of sE-cad herin before chemotherapy in patients different clinical stages and different chemotherapy efficacy ( P < 0.05). Pearson correlation analysis showed that clinical stages and chemotherapy efficacy were positively correlated with sE-cadherin level before chemotherapy ( r =0.394, 0.398 respectively, P <0.05). Conclusion The lower the expression intensity of E-cadherin, the higher serum sE-cadherin level and they are correlated with clinical stages and the TAC chemotherapy effects. E-cadherin and sE-cadherin can be used important indicators to evaluate the progress and prognosis of breast cancer.