间隙连接蛋白43表达水平预测乳腺癌新辅助化疗疗效的效能分析

Analysis of the effect of connexin 43 expression level in breast cancer on predicting the efficacy of neoadjuvant chemotherapy

目的分析间隙连接蛋白43(connexin 43,Cx43)表达水平预测乳腺癌新辅助化疗疗效的效能。方法选取保定市第二中心医院2018年12月至2021年12月收治的85例乳腺癌患者,于新辅助化疗前使用空心针穿刺活检取其病灶组织,使用免疫组化S-P法测定肿瘤细胞Cx43表达水平;化疗2个周期后评价两组患者的化疗效果。对比Cx43阳性表达、阴性表达患者新辅助化疗疗效,运用受试者操作特征曲线(receiver operator characteristic curve,ROC曲线)分析乳腺癌患者病灶组织Cx43表达水平预测患者新辅助化疗疗效的效能。结果85例乳腺癌患者中,34.12%(29/85)检出病灶组织Cx43表达阳性,其中10.34%(3/29)为强阳性。新辅助化疗2周后,85例患者总有效率为28.24%(24/85),Cx43表达阳性者总有效率为48.28%,高于Cx43表达阴性者的17.86%,(P<0.05)。多因素Logistic回归分析显示,肿瘤最大径每增大1 cm,患者新辅助化疗无效风险增加5.217倍,且临床分期Ⅲ期、小叶癌、淋巴结转移均为影响患者新辅助化疗疗效的独立危险因素(均P<0.05),病灶组织Cx43表达阳性为保护性因素(P<0.05)。ROC曲线分析显示,病灶组织Cx43表达阳性预测患者新辅助化疗有效的敏感度为79.17%、特异度为83.61%,曲线下面积为0.778。结论乳腺癌患者病灶组织Cx43表达水平普遍较低,且Cx43阴性表达者对新辅助化疗的反应有限,而病灶组织Cx43阳性者更易从新辅助化疗中获益。

Objective To analyze the expression level of connexin 43(Cx43)in breast cancer and its efficacy in predicting the curative effect of neoadjuvant chemotherapy.Method Eighty-five patients with breast cancer treated in Baoding Second Central Hospital from December 2018 to December 2021 were selected.Before neoadjuvant chemotherapy,hollow needle biopsy was used to obtain the lesion tissue,and the expression level of Cx43 in tumor cells was determined by immunohistochemical S-P method.After 2 cycles of chemotherapy,the chemotherapy effects of the two groups were evaluated.Comparing the efficacy of neoadjuvant chemotherapy in patients with positive and negative expression of Cx43,receiver operator characteristic curve(ROC curve)was used to analyze the efficacy of Cx43 expression in breast cancer tissues to predict the efficacy of neoadjuvant chemotherapy.Result Among the 85 cases of patients with breast cancer,34.12%(29/85)were positive for Cx43,of which 10.34%(3/29)were strongly positive.After 2 weeks of neoadjuvant chemotherapy,the total effective rate of 85 cases of patients was 28.24%(24/85),and that of Cx43positive patients was 48.28%,which was higher than that of Cx43 negative patients(17.86%)(P<0.05).Logistic regression analysis showed that the risk of ineffective neoadjuvant chemotherapy increased by 5.217 times when the tumor diameter increased by 1cm,and clinical stageⅢ,lobular cancer and lymph node metastasis were independent risk factors affecting the curative effect of neoadjuvant chemotherapy(all P<0.05),and the positive expression of Cx43 in the focus tissue was a protective factor(P<0.05).ROC curve showed that the sensitivity,specificity and AUC of the positive expression of Cx43 in the lesion tissue were 79.17%,83.61%and 0.778,respectively.Conclusion The expression level of Cx43 in breast cancer lesions is generally low,and those with negative expression of Cx43 have limited response to neoadjuvant chemotherapy,while those with positive expression of Cx43 are more likely to benefit from neoadjuvant chemotherapy.