CAF方案新辅助化疗对乳腺癌组织BCSG1蛋白表达的影响(英文)

目的探讨CAF联合化疗方案的新辅助化疗对乳腺癌组织BCSG1蛋白表达的影响。方法采用免疫组化SP法分别检测34例行CAF联合方案新辅助化疗患者(新辅助化疗组)和同期110例未行新辅助化疗患者(对照组)手术切除的乳腺癌组织BCSG1蛋白表达。同时对新辅助化疗组疗效进行病理形态学评价,并分析BCSG1蛋白表达与病理形态学变化的关系。结果新辅助化疗组化疗总有效率为79．4％。新辅助化疗组BCSG1蛋白高表达率明显低于对照组(29．4％比64．5％,P<0．01),化疗后部分缓解(Ⅱ级)病例BCSG1蛋白高表达水平明显低于无效(Ⅲ级)病病(P=0．002)。结论采用CAF方案新辅助化疗近期疗效明显,可抑制乳腺癌BCSG1蛋白的表达。     

新辅助化疗对乳腺癌组织BCSG1和maspin表达的影响

目的:探讨新辅助化疗对乳腺癌组织BCSG1、maspin表达的影响和意义。方法:采用免疫组化SP法和RT-PCR方法检测25例行新辅助化疗的患者(CAF组)和同期29例未化疗组患者手术切除的乳腺癌组织BCSG1、maspin的表达情况。对化疗组疗效进行病理形态学评价,并分析BCSG1、maspin蛋白表达与病理形态学的关系。结果:54例乳腺癌患者中,新辅助化疗组BCSG1蛋白高表达率低于对照组,χ2=7·569,P=0·006;部分缓解(Ⅱ级)病例BCSG1蛋白表达水平低于无效(Ⅲ级)者,P=0·017。化疗组细胞核maspin蛋白高表达率明显高于对照组,χ2=4·685,P=0·03。化疗后部分缓解Ⅱ级病例与无效者Ⅲ级细胞核maspin蛋白表达水平差异无统计学意义,P=0·073。在分子水平上,BCSG1mRNA表达CAF组明显低于未化疗组,t=-2·315,P=0·026。而maspinmRNA表达CAF组同样低于未化疗组,t=-2·352,P=0·023。结论:新辅助化疗可抑制乳腺癌细胞BCSG1蛋白的表达,同时可部分恢复乳腺癌细胞核的maspin蛋白的表达。在蛋白和分子水平,均提示BCSG1表达在监测乳腺癌化疗疗效上有一定的价值。     

新辅助化疗对乳腺癌组织MasPin蛋白表达的影响

目的:探讨CAF联合化疗方案的新辅助化疗对乳腺癌组织Maspin蛋白表达的影响.方法:采用免疫组化SP染色法分别检测38例行CAF联合方案新辅助化疗患者(化疗组)和同期173例未行新辅助化疗患者(对照组)手术切除的乳腺癌组织Maspin蛋白表达.同时对化疗组化疗疗效进行病理形态学评价,并分析Maspin蛋白表达与病理形态学变化的关系.结果:化疗组总有效率为81.6%.两组病例癌细胞胞浆的Maspin蛋白阳性表达率无明显差异(93.6%,97.4%).化疗组胞核Maspin蛋白高表达率明显高于对照组(50.0%,40.5%,P<0.05),其中,化疗组强阳性表达率7.9%,而对照组仅为0.6%(P<0.05).化疗后部分缓解(Ⅱ级)病例细胞核Maspin蛋白表达水平明显高于无效者(Ⅲ级)(P<0.01).结论:采用CAF方案新辅助化疗近期疗效明显,可部分恢复乳腺癌细胞核Maspin蛋白的表达.     

三阴乳腺癌新辅助化疗前后BCSG1基因表达的分析

目的观察乳腺癌特异基因BCSG1在三阴乳腺癌新辅助化疗前后分子和蛋白水平的变化。方法采用免疫组化SP法和荧光定量PCR方法检测49例三阴乳腺癌患者新辅助化疗(TA方案)前后乳腺癌组织BCSG1的表达情况,比较化疗前后肿瘤体积的变化,分析新辅助化疗前后BCSG1蛋白表达与肿瘤大小的关系。结果 43例乳腺癌患者新辅助化疗后肿瘤体积均有明显缩小,病灶缓解率(CR+PR)为87.8%;新辅助化疗后BCSG1mRNA表达水平亦明显低于化疗前蛋白表达(P0.05)。新辅助化疗后BCSG1蛋白表达率低于新辅助化疗前蛋白表达(P0.01)。结论 BCSG1分子和蛋白水平在三阴乳腺癌新辅助化疗后均明显降低,与新辅助化疗后疗效呈负相关(r=0.704,P=0.000),提示BCSG1可作为三阴乳腺癌新辅助化疗疗效的预测因子。     

BCRP和Ki-67与乳腺癌新辅助化疗疗效的关系

目的:探讨乳腺癌组织中乳腺癌耐药蛋白(breast cancer resistance protein,BCRP)和Ki-67的表达与新辅助化疗疗效之间的关系.方法:回顾性分析我科2012 年10月至2014年8 月收治的Ⅱ-Ⅲ期乳腺癌新辅助化疗患者65例,采用免疫组化方法检测BCRP和Ki-67的表达,分析BCRP、Ki-67的表达水平与新辅助化疗疗效的关系.结果:原发性乳腺癌组织中BCRP的阳性表达率为67.7%.BCRP的表达水平与新辅助化疗后病理组织学反应有关,组织学显著反应组(病理反应4~5级)BCRP的表达水平明显低于非显著反应组(病理反应1~3级),差异有统计学意义(x2=12.77,P=0.001).化疗前Ki-67高表达组临床缓解率明显高于低表达组(x2=17.72,P<0.00). 结论: 联合检测乳腺癌组织中BCRP和Ki-67 的表达水平对新辅助化疗疗效有一定的预测价值.     

新辅助化疗后乳腺癌组织中survivin、Ki-67和 AI的表达及其临床意义

目的探讨新辅助化疗后乳腺癌组织中survivin、Ki-67和AI的表达及其临床意义。方法采用免疫组化SABC法,检测60例行新辅助化疗和60例未行新辅助化疗的乳腺癌组织中survivin和Ki-67的表达,采用原位细胞末端转移标记法(TUNEL法)检测细胞凋亡。结果新辅助化疗组survivin和Ki-67阳性率分别为36.7%和38.3%,明显低于对照组(71.7%,61.7%),P均<0.05;新辅助化疗组AI均数为(9.34±3.12)%,低于对照组(5.27±3.16)%,P<0.05;新辅助化疗组survivin的表达与AI呈负相关,而与Ki-67表达呈正相关。新辅助化疗组化疗总有效率为73.3%,化疗后部分缓解者(Ⅱ级)病例survivin阳性率(18.2%)明显低于无效者(Ⅲ级)(81.3%),P<0.01。结论CTF方案新辅助化疗,可能通过抑制乳腺癌survivin表达而抑制肿瘤的增殖和诱导其凋亡。     

乳腺癌组织中端粒酶逆转录酶的表达及新辅助化疗后的变化

背景与目的:乳腺癌组织端粒酶逆转录酶(hTERT)在乳腺癌患者新辅助化疗中的作用仍不清楚.本研究探讨新辅助化疗对hTERT表达的影响.方法:2004年2月-2007年6月对53例可手术女性乳腺癌患者采用CEF方案新辅助化疗3个周期,采用RT-PCR和免疫组化法检测化疗前、后乳腺癌组织中hTERT的mRNA和蛋白表达变化.结果:新辅助化疗前癌组织中hTERT mRNA和蛋白的阳性表达率分别为77.4%、73.6%,两者间差异无显著性(P=0.791),而采用Spearman相关检验两者呈显著正相关(r=0.289,P=0.036).新辅助化疗后hTERT mRNA和蛋白阳性表达率(28.3%,22.6%)均显著低于新辅助化疗前.hTERT mRNA及蛋白阳性表达的患者新辅助化疗有效率显著低于hTERT mRNA及蛋白阴性表达者(P值均<0.05). 结论:新辅助化疗后hTERT基因明显下调;hTERT阴性表达患者新辅助化疗疗效更明显,可作为预测新辅助化疗疗效的一个重要参考指标.     

环磷酰胺联合5-氟尿嘧啶和氨甲喋呤与紫杉醇联合表阿霉素方案治疗乳腺癌的疗效及其对雌激素受体表达的影响

目的探讨新辅助环磷酰胺联合5-氟尿嘧啶、氨甲喋呤(CMF)方案与紫杉醇+表阿霉素(TA)方案治疗乳腺癌的临床疗效及对雌激素受体(ER)表达的影响。方法选择2013年1月至2014年1月间收治的80例乳腺癌患者,按照就诊顺序随机分为观察组和对照组,每组各40例,观察组患者采用新辅助TA方案化疗,对照组患者采用新辅助CMF方案化疗,观察并比较两组患者临床疗效及ER表达情况。结果观察组化疗的有效率为67.5%,控制率为82.5%;对照组的有效率为47.5%,控制率为67.5%,差异均有统计学意义(均P<0.05);治疗后观察组ER表达(-)级所占比例为27.5%,较治疗前和对照组均降低(均P<0.05);治疗后观察组ER表达(+)级、(++)级和(+++)级所占比例分别为35.0%、27.5%和10.0%,较治疗前和对照组均提高(均P<0.05)。结论新辅助TA化疗方案治疗乳腺癌疗效确切且明显优于新辅助CMF方案,乳腺癌组织中,ER表达影响更大且与化疗疗效有关。     

乳腺癌组织中maspin和BCSG1蛋白表达及其意义

目的:探讨maspin和BCSG1蛋白在乳腺癌组织中的表达及其临床意义。方法:应用流式细胞术对94例乳腺癌组织中的maspin和BCSG1蛋白的表达情况进行定量检测,结合临床及病理形态学资料采用t检验、χ2检验、方差分析及直线相关分析讨论maspin和BCSG1蛋白表达的意义。结果:maspin和BCSG1蛋白表达在复发组比无复发组明显增高,且差异有统计学意义(t=-2.86,P=0.0055;t=-2.33,P=0.023);淋巴结转移组比无转移组明显增高,且差异有统计学意义(t=2.91,P=0.004;t=3.42,P=0.001);直线相关分析显示,maspin和BCSG1两者密切相关,r=0.553,P=0.000。在BCSG1的FI值≥4的病例中复发转移病例明显增多(χ2=6.86,P=0.009),但两者均与患者年龄(t=1.129,P=0.262;t=0.808,P=0.421)、肿瘤大小(t=0.078,P=0.938;t=0.002,P=0.998)、临床分期(Fmaspin=0.658,FBCSG1=0.463;Ⅰ和Ⅱ比较:P=0.537,P=0.426;Ⅱ和Ⅲ比较:P=0.458,P=0.371;Ⅰ和Ⅲ比较:P=0.725,P=0.537)无关。结论:BCSG1蛋白可能作为预测乳腺癌预后的参考指标,而maspin蛋白预测乳腺癌预后的价值尚需进一步证实。     

Maspin BCSG1及c-erbB-2表达与乳腺癌预后的关系

目的:探讨Maspin、BCSG1、c-erbB-2蛋白在乳腺癌中的表达及其与预后的关系.方法:选取临床病理资料完整并随访5年以上的137例乳腺癌病例,采用SP免疫组织化学技术检测乳腺癌组织中的Maspin、BCSG1、c-erbB-2蛋白的表达情况,结合临床及病理形态学资料用COX模型分析Maspin、BCSG1、c-erbB-2表达对预后的影响.结果:Maspin、BCSG1、c-erbB-2蛋白在乳腺癌组织中的阳性表达率分别为48.9%,67.2%,27.7%三者与生存时间显著相关(P＜0.01).结论:Maspin、BCSG1、c-erbB-2蛋白在乳腺癌中的表达与患者的生存期密切相关,可作为预测乳腺癌预后的参考指标.     

Effect of Neoadjuvant CAF Regimen on the Expression of BCSG1 in Breast Cancer

Objective： To evaluate the efficacy of neoadjuvant chemotherapy and explore a sensitive and objective way in the evaluation of neoadjuvant chemotherapy, the pathological changes and BCSG1 expression were studied by pathological and immunohistochemical method in breast cancer patients with CAF neoadjuvant chemotherapy （Cyclophosphamide, Adriamycin and Fluorouracil, CAF） and those without at the same period. Methods： Specimens were obtained from 34 breast cancer patients receiving neoadjuvant CAF regimen chemotherapy （CAF group） and 110 breast cancer patients not receiving neoadjuvant chemotherapy （control group）. The BCSG1 expression was detected by SP immunohistochemistry. Correlation between BCSG1 expression and pathological response to CAF neoadjuvant chemotherapy was analyzed. Results： Overall response rate to neoadjuvant chemotherapy was 79.4%. The strong cytoplasm expression of BCSG1 was significantly lower in CAF group than in control group （29.4% vs. 64.5%, P〈0.01）. In CAF group, the positive cytoplasm expression in partial response （PR） （grade Ⅱ） cases was significantly lower than that in no response （NR） （grade Ⅲ） cases （P=0.002）. Conclusion： Neoadjuvant chemotherapy of CAF regimen could decrease the nuclear expression of BSCG1 in breast cancer.     

不同化疗方案对MCF-7乳腺癌荷瘤裸鼠的抑瘤作用及对PCNA表达的影响

Objective: To investigate the antitumor activity of different combination regimens to human breast cancer xenograft (MCF-7) transplanted in nude mice and the effects on the expression of PCNA, and to evaluate the value of PCNA as predictive factor for the response of chemotherapy and individualized treatment. Methods: (1) 88 nude mice models of human breast cancer xenograft (MCF-7) were established, and then were randomly divided into control group and 10 chemotherapy groups (each group, n = 8). Among them, the mice of 5 chemotherapy groups were treated intraperitoneally/orally by 5 combination chemotherapy regimens (CMF, CAF, NP, TP, Xeloda) respectively at 1/3 LD10 dosage schedule (dose lethal to 10%of the mice), and that in another 5 chemotherapy groups were treated at 2/3 LD10 dosage schedule. Control animals were administered intraperitoneally with normal saline. (2) The body weight of nude mice and transplanted tumor growth were observed and recorded, then inhibition rate of tumor growth was calculated. (3) The pathological features of transplanted tumor were studied under microscope. The expression of proliferating cell nuclear antigen (PCNA) was comparatively studied in chemotherapy group and control group by SP immunohistochemical method and flow cytometry analysis. Results: (1) Body weight, tumor weight and inhibition rate of tumor growth of athymic mice bearing cancer: Body weights and tumor weights of nude mice in every 2/3 LD10 chemotherapy group were significantly lower than those of the control group (P ＜ 0.05), and the inhibition rates of tumor growth were 83.1%, 75.5%, 84.6%, 87.9% and 91.0%, respectively. Body weights of athymic mice in every 1/3 LD10 chemotherapy group were lower than that of the control (P ＜ 0.05). The results showed that the 2/3 LD10chemotherapy groups could reflect the effect of combination chemotherapy on the nude mice and the clinical dependability was better. So the data of 2/3 LD10 chemotherapy groups were appropriated for successive study. (2) Immunohistochemical studies: The expressions of PCNA in every chemotherapy group were significantly lower than that of the control (P ＜ 0.05).Moreover, the expression of PCNA in NP group was significantly lower than those of CMF, CAF, TP and Xeloda groups (P ＜0.05), while the expressions of TP and Xeloda groups were significantly lower than those of CMF and CAF groups (P ＜ 0.05).(3) FCM analysis: FI values of PCNA in every chemotherapy group were significantly lower than that of the control (P ＜ 0.05).FI values of PCNA in TP and Xeloda groups were significantly lower than those of CMF and CAF groups (P ＜ 0.05), while the value of NP group was significantly lower than that of CMF group (P ＜ 0.05). (4) Relationship between PCNA expression and pathologic response: The expression of PCNA was significantly correlated with pathological therapeutic response of transplanted breast carcinoma (P = 0.001). Conclusion: In vivo chemosensitivity testing with 2/3 LD10 dosage combinations in nude mice bearing cancer can reflect the effects of chemotherapeutics and affects of organism exactly. Various chemotherapy regimens all can decrease the expression of PCNA in breast cancer. The PCNA can be regarded as the factor to judge the response to chemotherapy, and it become possibly one of the prospective factors in the selection of chemotherapy regimen and play a rule in individualized therapy in the clinic.     

不同化疗方案对裸鼠MCF-7乳腺癌移植瘤PCNA和Bcl-2表达的影响

目的：研究不同化疗方案对乳腺癌组织PCNA和Bcl-2的影响,探讨二者与化疗的关系及评价疗效的价值。方法：制备MCF-7乳腺癌荷瘤裸鼠模型,化疗后观察移植瘤病理组织学疗效,用免疫组化SP法显示乳腺癌组织PCNA和Bcl-2表达情况。结果：（1）各化疗组瘤组织PCNA表达显著低于对照组（P〈0．05）,且NP、TP和Xeloda组显著低于CMF、CAF组（P〈0．05）。PCNA表达与病理疗效显著相关（P=0．001）。（2）CAF、NP、TP和Xeloda化疗组Bcl-2蛋白表达显著高于对照组（P〈0．05）,且TP组显著高于CMF、CAF组（P〈0．05）。Bcl-2表达与病理疗效无显著相关性（P=0．093）。结论：化疗可降低乳腺癌组织PCNA表达,并增强Bcl-2的表达,且不同化疗方案对二者影响的差异有显著性。PCNA可作为评价乳腺癌化疗效果的参考指标,对选择化疗方案可能有指导意义。     

Response of Triple Negative Breast Cancer to Neoadjuvant Chemotherapy: Correlation between Ki-67 Expression and Pathological Response

Triple-negative breast cancers constitute about 15% of all cases, but despite their higher response to neoadjuvant chemotherapy, the tumors are very aggressive and associated with a poor prognosis as well as a higher risk of early recurrence. This study was retrospectively performed on 101 patients with stage II and III invasive breast cancer who received 6–8 cycles of neo-adjuvant chemotherapy. Out of the total, 23 were in the triple negative breast cancer subgroup. Nuclear Ki-67 expression in both the large cohort group (n=101) and triple negative breast cancer subgroup (n=23) and its relation to the pathological response were evaluated. The purpose of the study was to identify the predictive value of nuclear protein Ki-67 expression among patients with invasive breast cancers, involving the triple negative breast cancer subgroup, treated with neoadjuvant chemotherapy in correlation to the rate of pathological complete response. The proliferation marker Ki-67 expression was highest in the triple negative breast cancer subgroup. No appreciable difference in the rate of Ki-67 expression in triple negative breast cancer subgroup using either a cutoff of 14% or 35%. Triple negative breast cancer subgroup showed lower rates of pathological complete response. Achievement of pathological complete response was significantly correlated with smaller tumor size and higher Ki-67 expression. The majority of triple negative breast cancer cases achieved pathological partial response. The study concluded that Ki-67 is a useful tool to predict chemosensitivity in the setting of neoadjuvant chemotherapy for invasive breast cancer but not for the triple negative breast cancer subgroup.     

可手术乳腺癌新辅助化疗近期疗效观察

目的 研究可手术乳腺癌患者手术前给予新辅助化疗(NCT)的安全性、近期疗效以及对手术方式的影响。方法 我院于1997年3月～2001年12月收治的224例可手术乳腺癌患者(Ⅱ～Ⅲ期)术前随机给予CMF(CTX+MIX+5-Fu)方案或CAF(CTX+ADM+5-Fu)方案化疗两个周期,全部患者治疗前均经针吸细胞学检查确诊,评价其近期疗效和毒性反应,将临床原发肿瘤对化疗的反应按WHO标准分为完全缓解(CR)、部分缓解(PR)、无效(NR)或进展(PD)。结果 全部224例化疗患者中,CR 17例,PR 136例,总有效率68.3％,无恶化病例;毒性反应主要表现为胃肠道反应和骨髓抑制。胃肠道反应主要表现为恶心、呕吐,其中Ⅱ～Ⅲ级为65.6％;骨髓抑制以白细胞减少为主,Ⅲ～Ⅳ级白细胞减少发生率为60.3%,经对症治疗后均可缓解。全部患者无因为化疗的毒性反应而终止治疗的病例。结论 对于可手术乳腺癌的患者手术前给予新辅助化疗(NCT)可以使原发灶明显缩小,能够为预测化疗效果提供实体依据,降低手术复杂性,缩小手术范围,提高患者术后的生活质量,并且安全可行,是一种提高治疗效果的重要治疗方法。     

乳腺癌新辅助化疗86例临床观察

目的：观察乳腺癌新辅助化疗的临床效果，并探讨其临床价值。方法：2004年6月-2007年2月收治乳腺癌患者86例，予以新辅助化疗（rIThpC方案），即：多西紫杉醇（艾素）100mg，d1；吡柔比星60mg，d1；环磷酰胺0．8g，d1。21d为1周期，2—5个周期后观察客观有效率、病理缓解率及新辅助化疗前后免疫组化指标的变化。结果：新辅助化疗后临床完全缓解（cCR）者19例，占22．09％，部分缓解（cPR）者51例，占59．30％，病情稳定（SD）者16例，占18．60％，无疾病进展（PD）患者；病理学完全缓解（pCR）者7例，占8．14％。21例患者新辅助化疗后的ER、PR、C-erbB-2的阳性表达率均低于新辅助化疗前，但未达到统计学差异（P〉0．05）。结论：乳腺癌新辅助化疗可以有效的缩小肿瘤，降低肿瘤分期，提高行改良根治术及保乳术几率，逆转可能存在的全身转移，为化疗方案提供药敏依据；新辅助化疗可使乳腺癌患者ER、PR、C-erbB-2的阳性表达降低，临床应根据术前免疫组化结果制定相关术后辅助治疗方案，才可能使患者有更大的获益。     

异长春花碱联合顺铂治疗乳腺癌肺转移瘤

目的 :观察化疗药物异长春花碱联合顺铂对晚期乳腺癌肺转移瘤治疗效果。方法 :用常规剂量长春花碱联合顺铂 (NP)与环磷酰胺加阿霉素加 5 氟尿嘧啶联合 (CAF)的两种化疗方案分别治疗 2 8例和 32例晚期乳腺癌肺转移瘤 ,按WHO标准评价疗效进行分析对比。结果 :在NP方案中 ,化疗总有效率为 4 6 4 % ,比CAF方案的 2 8 1%有效率显著为高 ,能明显改善病人的呼吸系统症状 ,且比CAF方案能显著延长病人的生存期 ,但造血系统抑制比CAF方案严重。结论 :诺维本联合顺铂治疗晚期乳腺癌肺转移瘤具有较好的远近期效果 ,但需注意其易出现骨髓抑制和发生静脉炎的毒付作用。     

局部晚期乳腺癌新辅助化疗临床疗效及病理反应与预后的关系

目的探讨局部晚期乳腺癌新辅助化疗后,临床体征与病理改变相关性及对预后的影响。方法1999年6月至2003年6月,对46例局部晚期乳腺癌患者以针吸细胞学明确乳腺癌诊断后行新辅助化疗CAF或CEF方案2周期,化疗前、后观察肿瘤大小及术后病理表现,术后对患者进行随访。结果原发灶临床有效率为45.7%,完全缓解(CR)2.2%,部分缓解(PR)43.5%,病理有效率为54.4%,重度组织反应17.4%,中度组织反应37.0%,术后中位随访期36个月,健康生存26例,余20例中,其中有2例患者失访,18例中死亡10例,复发8例。结论新辅助化疗后,认为病理有效的患者的无瘤生存率高于临床有效的患者、生存时间长于临床有效的患者,病理有效才能影响患者的预后。