三阴性乳腺癌组织中TOPK的表达及其与新辅助化疗治疗反应和预后的相关性

Correlation between TOPK expression and response and prognosis of neoadjuvant chemotherapy for triple-negative breast cancer

目的:探讨T-LAK细胞起源的蛋白激酶(TOPK)在三阴性乳腺癌(TNBC)组织中的表达和作用,研究TOPK表达与新辅助化疗(NACT)治疗反应和预后的关系。方法:收集66例采用多西他赛+表柔比星+环磷酰胺(TEC)NACT方案的TNBC患者治疗前后的组织学标本,用免疫组化的方法检测TOPK和Ki-67的表达,采用Miller-Payne(MP)系统评估治疗反应,并对患者的无进展生存期(PFS)进行生存分析。结果:MP分级较低(1-3级)的患者组织中的TOPK阳性率高于MP分级较高(4-5级)的患者,在NACT治疗中TOPK阳性患者的预后不佳。同时发现MP 1-3级患者在NACT后组织中TOPK表达升高,而MP 4-5级患者NACT后组织中TOPK表达降低。NACT治疗后组织中TOPK升高的患者的PFS较TOPK降低者差。接受者操作特性曲线(ROC)结果表明,NACT前后患者组织中TOPK表达变化对预后的评估准确性更高。结论:TNBC组织中TOPK水平高的患者对NACT治疗反应不佳,并且预后较差。TOPK表达水平可能提示TNBC的NACT治疗反应和预后。

Objective:To investigate the expression and role of TOPK in triple-negative breast cancer(TNBC),and to study the relationship between TOPK expression and neoadjuvant chemotherapy(NACT)response and prognosis.Methods:Sixty-six histological specimens before and after treatment of patients with triple-negative breast cancer who received docetaxel+epirubicin+cyclophosphamide(TEC)neoadjuvant chemotherapy were enrolled.Immunohistochemistry was used to detect TOPK and Ki-67.Expression was assessed using the Miller-Payne(MP)system and survival analysis was performed on progression-free survival in patients.Results:Patients with lower MP grade(1-3)had higher TOPK positive rate than patients with higher MP grade(4-5),and patients with high TOPK positive rate during NACT treatment had a poor prognosis.At the same time,it was found that MP 1-3 patients had elevated TOPK expression after NACT,while MP 4-5 patients had lower TOPK expression after NACT.The progression-free survival(PFS)of patients with elevated TOPK after NACT treatment was worse than those with lower TOPK.Conclusion:Patients with high TOPK levels in TNBC have a poor response to NACT and have a poor prognosis.TOPK expression level may suggest a NACT treatment response and prognosis for TNBC.