摘要
目的探讨局部晚期乳腺癌新辅助化疗（NCT）前后血清基质金属蛋白酶-9（MMP-9）水平的变化及其对疗效的预测价值。方法检测本院2012年7月至2013年6月收治的80例Ⅱ-Ⅲ期乳腺癌患者NCT前后的血清MMP-9水平并评价NCT疗效。64例ER、PR阳性乳腺癌患者采用EC-T方案化疗（表阿霉素90mg／in。静滴，d1；环磷酰胺600mg／m2静滴，d．，21天为1周期，共4个周期；序贯多西他赛80mg／m2静滴，d1，21天为1周期，共4个周期），16例ER、PR阴性者采用TEC方案化疗（多西他赛75mg／m2静滴，d1；表阿霉素75～85mg／m2静滴，d1；环磷酰胺600mg／m2静滴，d1，21天为1周期，共4个周期）。分析血清MMP-9水平与NCT疗效及临床病理特征的关系。结果80例患者共完成NCT290个周期，有效率（RR）为78．8％（63／80），其中获CR4例，PR59例。38例（47．5％）临床分期降低。NCT前血清MMP-9阳性组（〉900U／L）和阴性组（≤900U／L）的RR分别为85．2％（46／54）和65．4％（17／26），差异有统计学意义（P〈0．05）。血清MMP-9水平与乳腺癌化疗前分期、HER-2、ER／PR状态及病理学反应性分级均有关（P〈O．05）。在化疗有效、化疗前分期Ⅲ期、HER-2＋、ER＋、PR-／＋、病理学反应性分级G1-G3，和G4-G5，及绝经和未绝经的患者中，化疗2个周期后的血清MMP-9水平与化疗前比较明显降低（P〈0．05）。结论血清MMP-9水平对乳腺癌NCT疗效具有一定的预测价值，可减少NCT的盲目性，有助于制定有效的治疗方案。
Objective To investigate the significance of serum matrix metalloproteinase-9（MMP-9） in predicting efficacy of neoadjuvant chemotherapy（NCT） for locally advanced breast cancer. Methods Eighty breast cancer patients of stage ]] -]U from July 2012 to June 2013 were enrolled in this study. Sixty-four patients with positive expression of ER and PR received EC-T regimen（ epiru- bicin 90mg/m2 iv d1 , cyclophosphamide 600mg/m2 iv d1 , 21 days was a cycle for 4 cycles; and then docetaxel 80mg/m2 iv d1 , 21 days was a cycle for 4 cycles）, and 16 patients with negative expression of ER and PR were applied with TEC regimen（ docetaxel 75mg/m2 iv d1 , epirubicin 75-85mg/m2 iv d,, cyclophosphamide 600mg/m2 iv dI , 21 days was a cycle for 4 cycles）. The relationship between clinical efficacy of NCT, clinicopathological features and serum MMP-9 levels was analyzed. Results Eighty patients received NCT of 290 cycles. The response rate（RR） was 78.8% （63/80） with 4 cases of CR and 59 cases of PR. The RR of serum MMP-9 pos- itive（〉900U/L） and MMP-9 negative（ ≤〈900U/L） in patients with breast cancer before NCT were 85.2% （46/54） and 65.4% （ 17/ 26 ） with significant difference（ P〈0.05 ）. The serum MMP-9 level was related to stages before NCT, the expression of HER-2, ER and PR condition, and pathological reactivity（ P〈0. 05）. The serum MMP-9 levels after 2 cycles of NCT in patients with effective results, stage I11 （before NCT）, HER-2＋, ER＋, PR-/＋, different pathological reactivity and menopause condition were significandy lower than those before NCT（ P〈0. 05 ）. Conclusion The serum MMP-9 level is of predictive value towards NCT for breast cancer, facilita- ting the development of effective treatment programs.
出处
《临床肿瘤学杂志》
CAS
2014年第1期38-41,共4页
Chinese Clinical Oncology
关键词
乳腺癌
新辅助化疗
基质金属蛋白酶-9
临床疗效
Breast cancer
Neoadjuvant chemotherapy
Metalloproteinase-9（MMP-9）
Clinical efficacy
