摘要
目的分析拓扑异构酶Ⅱα(TOP2Α)与乳腺癌临床特征的关系及其对新辅助化疗效果的预测价值。方法回顾性分析349例乳腺癌手术患者的病历资料,其中93例患者术前接受了4~6个周期的新辅助化疗。采用免疫组化法检测349例乳腺癌患者癌组织中ER、PR、HER2、TOP2Α和Ki-67的表达情况,判断有无HER2蛋白扩增,分析TOP2Α表达与乳腺癌临床特征,ER、PR、TOP2Α、Ki-67表达及有无HER2蛋白扩增与病理完全缓解(PCR)的关系。结果 ER阴性、Ki-67高表达患者的TOP2Α表达阳性率分别明显高于ER阳性、Ki-67低表达患者,差异均有统计学意义(P<0.01);ER阴性、PR阴性、TOP2Α阳性、Ki-67高表达患者的PCR比例分别高于ER阳性、PR阳性、TOP2Α阴性、Ki-67低表达患者,差异均有统计学意义(P<0.05);而有无HER2蛋白扩增患者的PCR比例比较,差异无统计学意义(P>0.05);多因素Logistic回归分析显示,ER、PR、TOP2Α和Ki-67均不是新辅助化疗+乳腺癌手术患者PCR的独立预测因素,差异均无统计学意义(P>0.05),但TOP2Α和Ki-67的P值接近0.05(P=0.065、0.070)。结论 TOP2Α与Ki-67及ER表达有密切的关系,可以反映肿瘤细胞的增殖活性,可能成为乳腺癌新辅助化疗的预测指标。
Objective To analyze the relationship between topoisomerase Ⅱα（TOP2Α） and the clinicopathological characteristics of breast cancer, and its predictive value in the effect of neoadjuvant chemotherapy. Method The clinical data of 349 patients treated with breast cancer surgery were retrospectively analyzed, in which 93 received neoadjuvant chemotherapy with 4-6 cycles. The expression of ER, PR, HER2, TOP2Α and Ki-67 in 349 cases of breast cancer were detected by immunohistochemical assay and determined whether there was HER2 protein amplification. The relationship between TOP2Α and the clinical features, the correlation between ER, PR, HER2, TOP2 A, Ki-67 and pathological complete response（PCR） was analyzed. Result The positive rate of TOP2Α in patients with ER（-） and high Ki-67 was significantly higher than those with ER（＋） and low Ki-67, with statistically significant difference observed（P〈0.01）; the PCR rate was higher in patients with ER（-）, PR（-）, TOP2 A（＋） and high Ki-67 than in those with ER（＋）, PR（＋）,TOP2A（-）, and low Ki-67, showing statistically significant differences（P〈0.05）; while the amplification of HER2 protein was not related to PCR rate（P〉0.05）; Logistic multivariate regression analysis showed that ER, PR, TOP2Α and Ki-67 were not the independent predictors of PCR of the patients treated with neoadjuvant chemotherapy before breast cancer operation（P〉0.05）, but the P values of Ki-67 and TOP2Α were close to 0.05（P=0.064, 0.070）. Conclusion TOP2Αis highly correlated with the expression of Ki-67 and ER, reflecting the proliferative activity of tumor cells, and might be used as a predictor of neoadjuvant chemotherapy.
作者
乔江华
焦得闯
王丽娜
朱久俊
卢振铎
刘真真
QIAO Jianghua;JIAO Dechuang;WANG Lina;ZHU Jiujun;LU Zhenduo;LIU Zhenzhen(Department of Breast, He＇ nan Provincial Cancer Hospital （Affiliated Hospital of Zhengzhou University）, Zhengzhou 450008, He＇ nan, Chin)
出处
《癌症进展》
2018年第4期488-491,共4页
Oncology Progress
关键词
乳腺癌
拓扑异构酶Ⅱα
新辅助化疗
病理完全缓解
breast cancer
topoisomerase Ⅱα
neoadjuvant chemotherapy
pathological complete response
