HER2阴性乳腺癌BCRP和MTA1表达与新辅助化疗疗效的关系

Predictive value of BCRP and MTA1expressions on the efficacy of neoadjuvant chemotherapy in HER2negative breast cancer patients

目的探讨乳腺癌耐药蛋白(BCRP)和转移相关蛋白1(MTA1)共表达与HER2阴性乳腺癌新辅助化疗疗效的相关性。方法选取2017-01-01-2019-10-31郑州大学附属郑州中心医院收治的原发性浸润性乳腺癌患者102例作为研究对象,均为接受TEC方案新辅助化疗的HER2阴性乳腺癌患者。前瞻性研究分析102例患者临床资料,应用免疫组织化学法检测BCRP和MTA1在新辅助化疗前、新辅助化疗2个周期、新辅助化疗4个周期的乳腺癌组织中的表达水平,采用卡方检验分析BCRP和MTA1的表达水平与新辅助化疗疗效的关系。结果新辅助化疗前、新辅助化疗2和4个周期BCRP阳性表达率分别为35.29%(36/102)、49.02%(50/102)和60.78%(62/102),新辅助化疗前后比较差异有统计学意义,χ2=13.295,P=0.001;新辅助化疗前、新辅助化疗2和4个周期MTA1阳性表达率分别为57.84%(59/102)、61.76%(63/102)和70.59%(72/102),新辅助化疗前后比较差异无统计学意义,χ2=3.746,P=0.154。在新辅助化疗2个周期时,新辅助化疗有效组的BCRP阳性率和无效组相比差异无统计学意义,χ2=0.409,P=0.523;在新辅助化疗4个周期时,新辅助化疗有效组的BCRP阳性率明显低于无效组,差异有统计学意义,χ2=4.512,P=0.034。新辅助化疗前后MTA1高表达组临床缓解率均明显低于低表达组,P<0.05。新辅助化疗前后癌组织中BCRP和MTA1的表达均有较高的一致性(新辅助化疗前,χ2=14.825,r=0.381,P<0.001;新辅助化疗4个周期,χ2=20.754,r=0.451,P<0.001)。结论BCRP和MTA1的表达水平与TEC新辅助化疗疗效相关,两者联合检测对HER2阴性乳腺癌新辅助化疗疗效有一定的预测价值。

OBJECTIVE To explore the correlation of breast cancer resistance protein(BCRP)-Metastasis-associated protein 1(MTA1)co-expression with the efficacy of NAC for HER2-negative breast cancer.METHODS In this prospective study,102patients with HER2-negative breast cancer received NAC with TEC regimen.Immunohistochemistry was used to detect the expression of BCRP and MTA1prior to NAC and at NAC2and NAC4cycles,and chi-square test was used to analyze the correlation of BCRP and MTA1expression with the efficacy of NAC.RESULTS The expression rates of BCRP prior to NAC and at NAC2and NAC4cycles were 35.29%(36/102),49.02%(50/102)and 60.78%(62/102),respectively,with statistically significant differences from pre-NAC to post-NAC(χ2=13.295,P=0.001).The expression rates of MTA1prior to NAC and at NAC2and NAC4cycles were 57.84%(59/102),61.76%(63/102)and 70.59%(72/102),respectively,without statistically significant differences from pre-NAC to post-NAC(χ2=3.746,P=0.154).At NAC2cycle,there was no statistically significant difference between the NAC responder group and NAC non-responder group in BCRP expression rate(χ2=0.409,P=0.523).At NAC4cycle,the BCRP expression rate was significantly lower in NAC responder group than that in NAC non-responder group,with statistically significant difference(χ2=4.512,P=0.034).The clinical response rate was significantly lower in MTA1high expression group than that in MTA1low expression group prior to NAC and at NAC2and NAC4cycles(P<0.05).BCRP and MTA1expression in cancerous tissues showed high consistency prior to NAC and at NAC2and NAC4cycles(prior to NAC:χ2=14.825,r=0.381,P<0.001;at NAC4cycle:χ2=20.754,r=0.451,P<0.001).CONCLUSIONS BCRP and MTA1expression is correlated with the efficacy of NAC with TEC regimen.Detecting both BCRP and MTA1could be of some predictive value for the efficacy of NAC to HER2-negative breast cancer.