新辅助化疗前和化疗后乳腺癌组织中CD44+/CD24-/乙醛脱氧酶1细胞表型的变化及意义

目的 探究新辅助化疗(NAC)前后乳腺癌组织中CD44+/CD24-/乙醛脱氢酶1(ALDH1)+细胞表型的比例变化及其临床意义.方法 选取153例经空芯针穿刺活检明确病理诊断的乳腺浸润性导管癌患者为研究对象,临床Ⅱa～Ⅲb期,取NAC前后乳腺癌灶组织,应用免疫组织化学(IHC)单染及双染技术检测并比较化疗前后乳腺癌组织中ALDH1+、CD44+CD24-表型以及两者重叠表达的情况,并分析其与乳腺癌临床病理特征及化疗效果的关系.结果 NAC前患者乳腺癌组织中AL-DH1+/CD44+/CD24-表型的比例为7.2％,化疗后ALDH1+/CD44+/CD24-表型比例为22.9％,两者差异有统计学意义(χ2=14.737,P<0.001);化疗前CD44+/CD24-/ALDH1+表型的表达与肿瘤大小(χ2=5.889,P=0.015)、脉管癌栓(χ2=15.223,P<0.001)、HER-2(χ2=4.036,P=0.045)有显著相关性.NAC前表型为ALDH1+/CD44+/CD24-的患者NAC后有效率(81.8％)明显高于非ALDH1+/CD44+/CD24-表型的患者(45.4％)(χ2=5.748,P=0.017).结论 NAC可促进AL-DH1+/CD44+/CD24-的表型比例升高,ALDH1+/CD44+/CD24-的表型与化疗有效率相关,ALDH1+/CD44+/CD24-表型有可能可以作为预测乳腺癌患者NAC疗效的临床指标.

The proportion change of CD44 + /CD24 - /ALDH1 + phenotype cells in breast cancer before and after neoadjuvant chemotherapy

Objective To investigate the proportion change of CD44 +/CD24 -/ALDH1 + cells in breast cancer tissues before and after neoadjuvant chemotherapy and its clinical significance.Methods 153 breast infiltrating ductal carcinoma patients confirmed by core needle biopsy from January 2013 to December 2015,clinical stage Ⅱa-Ⅲb,were selected in this study.Double staining immunohisto-chemistry (IHC)was applied for the detection of CD44 +/CD24 - cells and single staining IHC for ALDH1 in breast cancer tissues be-fore and after neoadjuvant chemotherapy.Statistical analysis was performed to investigate the expression of ALDH1 +,CD44 +/CD24 -and CD44 +/CD24 -/ALDH1 +and to explore the relationship between the cell proportion of CD44 +/CD24 -/ALDH1 +type and clinico-pathologic features,as well as chemotherapeutic effects.Results 7.2％ breast cancer patients showed overlapped expression of CD44 +/CD24 -/ALDH1 +phenotype before neoadjuvant chemotherapy,compared to 22.9 ％ after neoadjuvant chemotherapy (χ2 =14.737,P <0.001 ).CD44 +/CD24 -/ALDH1 + phenotype was significantly related with tumor size(χ2 =5.889,P =0.015),intravas-cular cancer emboli (χ2 =15.223,P <0.001 ),HER-2 (χ2 =4.036,P =0.04).The chemotherapeutic effects (81 .8％)on the breast cancer with CD44 +/CD24 -/ALDH1 + phenotype was much higher than that with Non-CD44 +/CD24 -/ALDH1 + phenotype (45.4 ％)(χ2 =5.748,P =0.017).Conclusions Neoadjuvant chemotherapy could promote the expression of CD44 +/CD24 -/AL-DH1 +phenotype in breast cancer,and CD44 +/CD24 -/ALDH1 +phenotype was correlated with chemotherapeutic effects,which may be a potential clinical index to predict the chemotherapeutic effects and prognosis of breast cancer patients.