双磷酸盐在乳腺癌临床应用研究中的新进展

双磷酸盐（bisphosphonates,BPs）抑制破骨细胞介导的骨破坏,治疗乳腺癌骨转移疗效确切,成为乳腺癌骨转移的标准治疗。但近来研究结果表明BPs具有直接和间接的抗瘤活性,这使得BPs可能用于乳腺癌辅助治疗预防转移。BPs抗瘤效应还可直接诱导凋亡和抑制肿瘤趋化、移动、粘附和侵袭机制,可抑制乳腺癌细胞粘附于骨基质,间接效应还包括抑制内皮细胞增殖、血管生成以及免疫调节功能。此外,含氮BPs还有与细胞毒性药物协同效应,这些实验的结果将有可能为BPs更广泛应于乳腺癌辅助治疗奠定基础。临床数据也证实BPs不仅可以治疗骨转移,而且可以减少乳腺癌术后骨转移和内脏转移的发生,提高总生存率。也有数据提示BPs与化疗有协同作用,甚至有研究认为BPs可降低乳腺癌发生的危险。但BPs的临床数据还较有限并且其抗瘤效果尚存争议。有几项前瞻性临床试验正在进行以验证新一代BPs唑来磷酸在乳腺癌的抗瘤活性。本文对目前BPs在乳腺癌中的应用研究进展做一综述。      

Approval summary for zoledronic acid for treatment of multiple myeloma and cancer bone metastases.

PURPOSE: This article summarizes data submitted to the United States Food and Drug Administration for marketing approval of zoledronic acid (Zol; Novartis Pharmaceuticals, East Hanover, NJ), a bisphosphonate drug for treating patients with bone metastases. Experimental Design: We review the chemistry, toxicology, pharmacology, and clinical study results submitted to support the supplemental New Drug Application for Zol for treatment of patients with bone metastases. Four- and 8-mg Zol doses were selected for Phase III trials based on bone resorption markers and clinical efficacy parameters. Patients with bone metastases were randomized in three Phase III studies (prostate cancer, solid tumors, and multiple myeloma or breast cancer) to receive 4 or 8 mg of Zol or to a control arm. The control was a placebo in the prostate cancer study and the other solid tumor study and was 90 mg of pamidronate (Pam) in the study of breast cancer and multiple myeloma. Studies were amended twice because of renal toxicity, initially to increase Zol infusion time from 5 to 15 min and later to decrease the dose in the Zol 8-mg arm to 4 mg. The efficacy end point was skeletal-related events (SREs), a composite end point consisting of pathologic fracture, radiation therapy to bone, changes in antineoplastic therapy for bone pain (prostate cancer only), surgery to bone, or spinal cord compression. This end point was analyzed either as the proportion of patients with SRE or time to first SRE. The breast cancer and myeloma study used a noninferiority statistical analysis methods to determine efficacy. RESULTS: In prostate cancer, both the proportions analysis and time-to-SRE analysis showed significantly less bone morbidity on Zol (4 mg) than placebo, but no significant difference between Zol (8 mg) and placebo in either analysis. In the solid tumor study, the time to SRE analysis but not the proportions analysis showed significantly less skeletal morbidity on Zol (4 mg) than placebo, and Zol (8 mg) was significantly better than placebo in both analyses. The breast cancer and myeloma study demonstrated noninferiority of Zol compared with Pam, with Zol retaining at least 49.3% of the Pam treatment effect previously demonstrated in placebo-controlled trials. Zol was approved on February 22, 2002, by the United States Food and Drug Administration for the "treatment of patients with multiple myeloma and documented bone metastases from solid tumors, in conjunction with standard antineoplastic therapy. Prostate cancer should have progressed after treatment with at least one hormonal therapy." The recommended dose and schedule is 4 mg of Zol infused over 15 min every 3-4 weeks. Increased Zol doses and shorter infusions are not recommended because of potential renal toxicity.     

Mesenchymal stem cell secretion of chemokines during differentiation into osteoblasts,and their potential role in mediating interactions with breast cancer cells

Over 70% of patients with advanced breast cancer will develop bone metastases for which there is no cure. Mesenchymal Stem Cells (MSCs) and their derivative osteoblasts are subpopulations of cells within the bone marrow environment, postulated as potential interacting targets for disseminating cancer cells because of their ability to secrete a range of chemokines. This study aimed to investigate chemokine secretion throughout MSC differentiation into osteoblasts and their effect on the breast cancer cells. Primary MSCs and osteoblast progenitors were cultured in appropriate conditions to induce differentiation into mature osteoblasts. Chemokines secreted throughout differentiation were detected using ChemiArray and ELISA. Migration of breast cancer cells in response to the bone‐derived cells was quantified using Transwell inserts. Breast cancer cells were cocultured with MSCs, retrieved using magnetic beads, and changes in CCL2 expression were analyzed. MSCs secreted a range of factors including IL‐6, TIMP‐1 and CCL2, the range and level of which changed throughout differentiation. CCL2 secretion by MSCs increased significantly above control cells as they differentiated into mature osteoblasts (p < 0.05). The bone‐derived cells stimulated migration of breast cancer cells, and this was inhibited (21–50%) in the presence of a CCL2 antibody. CCL2 gene expression in breast cancer cells was upregulated following direct coculture with MSCs. The varying levels of chemokines secreted throughout MSC differentiation may play an important role in supporting tumor cell homing and progression. These results further highlight the distinct effect MSCs have on breast cancer cells and their potential importance in supporting development of metastases. © 2008 Wiley‐Liss, Inc.     

β-Lapachone对乳腺癌细胞增殖、迁移和凋亡的作用及机制

目的:探索β-Lapachone与乳腺癌细胞MCF-7和MFM223的细胞增殖、迁移和凋亡作用及机制。方法:采用β-Lapachone以不同浓度处理乳腺癌细胞MCF-7和MFM223,不同时间点后,进行MTT,细胞克隆实验,细胞增殖毒性实验,划痕实验,观察给药后对细胞的增殖和迁移能力,凋亡实验验证给药后对乳腺癌细胞的凋亡作用,Western blot实验检测迁移和凋亡相关蛋白的表达水平。结果:与对照组相比,β-Lapachone给药后乳腺癌细胞增殖,迁移能力随着浓度的增加而降低,凋亡相关蛋白水平与β-Lapachone给药浓度呈正相关,细胞中迁移相关蛋白（MMP-2/9、Ezrin、vimentin、Snail、GSK-3β）表达明显下调（P<0.05）,凋亡相关蛋白（Caspase-3/8/9）明显上调,BCL-2/Bax的比值下降（P<0.05）。结论:β-Lapachone能够有效抑制乳腺癌细胞增殖能力,通过EMT 途径抑制乳腺癌细胞迁移,Caspase依赖途径诱导乳腺癌细胞的凋亡。     

Role of estrogen-induced insulin-like growth factors in the proliferation of human breast cancer cells

Insulin-like growth factor I (IGF-I) is the most potent growth factor for estrogen (E2)-dependent breast cancer cell lines. It has been reported that such cell lines produce an immunoreactive IGF-I-related protein in an E2-dependent fashion, while autonomously growing cell lines constitutively produce these factors, indicating that they might be involved in autocrine growth stimulation of breast cancer cells. We have studied the role of IGFs in autocrine growth stimulation of the E2-dependent breast cancer cell line MCF7 by using IGF-binding proteins (BPs) that were able to neutralize completely the mitogenic effect of IGF-I on this cell line. These BPs, however, did not have any inhibitory effect on E2-induced mitogenesis, suggesting that secretion of autocrine IGFs is not involved in growth stimulation by E2. To exclude the possibility that variants of IGF are produced by the cells that are not recognized by the BPs, we also studied the production of biologically active IGF using the same MCF7 cell line in a sensitive bioassay in which the various forms of IGF and insulin can be detected. Although the conditioned medium (CM) of human fibroblasts used as a control showed IGF-like activity in this assay, no such activity was detected in CM of both untreated and E2-stimulated MCF7 cells, while the CM of the E2-independent cell lines BT20 and Hs578T had only slight mitogenic activity or was even growth inhibitory, respectively. These data show that no significant secretion of biologically active IGFs by human breast cancer cells could be detected and do not support a possible autocrine function of IGFs in the proliferation of such cells. Because E2-dependent cells strongly react to externally added IGF-like factors produced by human fibroblasts, a role for IGFs in paracrine regulation of proliferation is suggested.     

GRM4正向别构调节剂抑制乳腺癌细胞的增殖并促进细胞凋亡

背景与目的：代谢型谷氨酸受体4（glutamate metabotropic receptor 4，GRM4）在多种恶性肿瘤中高表达并与肿瘤患者的预后相关，但GRM4在乳腺癌中的生物学作用仍不清楚。本研究拟探讨GRM4的两种正向别构调节剂VU0364439及VU0364770对乳腺癌细胞的增殖及凋亡的影响，进而为乳腺癌的靶向治疗提供思路。方法：在体外培养的乳腺癌细胞系MDA-MB-231、MCF-7和SK-BR-3中分别单独加入VU0364439、VU0364770以及联合使用两种试剂，利用CellTiter-Glo^®发光细胞活力测定法定量检测各组乳腺癌细胞系的增殖活性；利用Annexin Ⅴ-PI双染法检测各组乳腺癌细胞系的凋亡水平；通过实时荧光定量聚合酶链反应（realtime fluorescent quantitative polymerase chain reaction，RTFQ-PCR）技术测定GRM4基因在6种乳腺癌细胞系中的表达情况，在GRM4表达水平最高的细胞中单独加入或联合使用VU0364439及VU0364770，用RTFQ-PCR检测GRM4基因表达的改变。结果：与对照组相比，单独使用及联合使用VU0364439及VU0364770显著抑制乳腺癌细胞MCF-7、MDA-MB-231和SK-BR-3的增殖水平，并促进MCF-7细胞凋亡现象的发生；联合使用与单独使用VU0364439及VU0364770对乳腺癌细胞增殖及凋亡的作用差异无统计学意义（P＞0.05）；RTFQ-PCR实验表明GRM4在MCF-7细胞中的表达水平最高；在MCF-7细胞中分别单独使用或联合使用VU0364439及VU0364770均能激活GRM4的表达。结论：GRM4的正向别构调节剂能够抑制乳腺癌细胞增殖并促进细胞凋亡，其作用可能是通过激活GRM4基因的表达引起的，本研究为探索GRM4在乳腺癌中的作用机制以及开发新的乳腺癌靶向治疗方法奠定了基础。     

Zoledronic acid is superior to pamidronate for the treatment of bone metastases in breast carcinoma patients with at least one osteolytic lesion

BACKGROUND: Treatment with zoledronic acid (Zol) was compared with a dose of 90 mg of pamidronate (Pam) in breast carcinoma (BC) patients with at least 1 osteolytic lesion based on data from a Phase III, randomized trial. METHODS: Overall, 1130 patients with breast carcinoma who had all types of bone metastases (osteolytic, mixed, or osteoblastic by radiology) were randomized to receive treatment with either 4 mg of Zol or 8 mg of Zol as a 15-minute infusion or 90 mg of Pam as a 2-hour infusion every 3-4 weeks for 12 months. A skeletal-related event (SRE) was defined as a pathologic fracture, spinal cord compression, radiotherapy, or surgery to bone. RESULTS: Among all patients with BC, the proportion of those who had an SRE (primary endpoint) was comparable between treatment groups (43% of patients who received 4 mg of Zol vs. 45% of patients who received Pam). Among patients who had breast carcinoma with at least 1 osteolytic lesion (n = 528 patients), the proportion with an SRE was lower in the 4-mg Zol group compared with the Pam group (48% vs. 58%), but this did not reach statistical significance (P = 0.058). The time to first SRE was significantly longer in the 4-mg Zol group compared with the Pam group (median, 310 vs. 174 days; P = 0.013). Moreover, multiple-event analysis demonstrated significant further reductions in the risk of developing SREs over the reduction achieved with Pam (30% in the osteolytic subset [P = 0.010] and 20% for all patients with BC [P = 0.037]). CONCLUSIONS: The current data indicate that treatment with 4 mg of Zol was more effective than 90 mg of Pam in reducing skeletal complications in a subset of patients with breast carcinoma who had at least 1 osteolytic lesion at study entry.     

Zoledronic acid, a third-generation bisphosphonate, inhibits cellular growth and induces apoptosis in oral carcinoma cell lines

Bisphosphonates (BPs) inhibit bone resorption by preventing osteoclast maturation and apoptosis induction. Recently, BPs have also been shown to have antitumor effects against various types of carcinomas in vitro and in vivo. In this study, we investigated the antitumor effect of zoledronic acid (ZOL), a third generation bisphosphonate, on proliferation, cell cycle and apoptosis of oral cancer cells. Direct antitumor effects of ZOL against four oral carcinoma cell lines (squamous cell carcinoma, HSC3, HSC4, SCCKN; salivary adenocarcinoma, HSY) were measured by WST assay. Apoptosis-related molecules were analyzed by Western blot analysis and cell cycle was analyzed by flow cytometry. ZOL had a dose-dependent antitumor effect in the four oral cancer cell lines. ZOL activated caspase-3, -8 and -9 and induced cellular apoptosis. Western blot analysis showed that ZOL increased cleaved anti-human poly(ADP-ribose) polymerase expression and decreased Bcl-2 and Bid expression. Treatment with ZOL increased the number of cells in apoptosis, sub G1 phase and S phase, and reduced the number of cells in the G0/G1 and G2/M phase in a concentration-dependent manner. ZOL inhibits cell proliferation and induces apoptosis of oral cancer cells in vitro. These findings suggest that ZOL might be beneficial in the treatment of oral carcinoma patients.     

The new bisphosphonate,Zometa (zoledronic acid), decreases skeletal complications in both osteolytic and osteoblastic lesions: a comparison to pamidronate

Bisphosphonates are the treatment of choice for lytic bone lesions associated with breast cancer. In contrast, bone lesions associated with prostate cancer are predominately osteoblastic. Zoledonic acid (Zol) is a new-generation bisphosphonate that is approximately 2-3 orders of magnitude more potent than pamidronate (Pam) in preclinical models and has demonstrated clinical efficacy in patients with both lytic and blastic lesions. Zoledonic acid (4 mg via 15 min infusion) every 3-4 weeks was directly compared to Pam (90 mg via 2 hr infusion) in 767 patients with breast cancer and bone metastases. The primary endpoint was the proportion of patients experiencing a skeletal-related event (SRE) over 13 months. Zoledonic acid was as effective as Pam, and the proportion of Zol-treated patients with an SRE (42% in the hormonal therapy strata and 44% in the chemotherapy strata) was comparable to the original studies comparing Pam to placebo. Among 371 breast cancer patients receiving hormonal therapy, the proportion of patients with an SRE was 47% for Pam vs. 57% for placebo (P = 0.057), and among 380 patients treated with chemotherapy, the proportions with an SRE were 43% for Pam vs. 56% for placebo (P = 0.008) at 12 months. Zoledronic acid (4 mg) has been compared to placebo in a randomized Phase III trial involving 422 men with hormone-refractory prostate cancer metastatic to bone. Zoledonic acid demonstrated a significant advantage over placebo for median time to first SRE (median not reached for Zol vs. 321 days for placebo; P = 0.011), the proportion of patients with an SRE over 15 months (33 vs. 44% for placebo; P = 0.021), and mean skeletal morbidity rate (number of SREs/time, 0.08 vs. 1.49 for placebo; P = 0.006). In addition, the effects of Zol were apparent early. At 3 months, only 12% of Zol-treated patients had an SRE vs. 23% for placebo (P = 0.003), and at 6 months, the proportions were 21 vs. 31% for placebo (P = 0.025). In contrast, a previous study of Pam in 236 prostate cancer patients found that Pam was no more effective than placebo in reducing bone pain or SREs over 6 months. In these studies, Zol was well tolerated with a safety profile similar to other IV bisphosphonates. In conclusion, Zol is the first bisphosphonate to demonstrate efficacy in both lytic and blastic disease. The unique properties of this novel agent should be further explored in future clinical trials.     

Bisphosphonates directly regulate cell proliferation, differentiation, and gene expression in human osteoblasts

Bisphosphonates are widely used clinically to treat bone diseases in which bone resorption is in excess. However, the mechanism of bisphosphonate action on bone is not fully understood. Studies of direct action of bisphosphonates on bone have been limited mainly to their effects on bone-resorbing osteoclast cells, with implications that some activity may be mediated indirectly through paracrine factors produced by the bone-forming osteoblast cells. Little is known about the direct effects of bisphosphonates on osteoblasts. In this report, the direct actions of several bisphosphonates on cell proliferation, gene expression, and bone formation by cultured human fetal osteoblasts were examined. Osteoblast cell proliferation was decreased, and cytodifferentiation was increased in a dose-dependent manner in cultures treated with the bisphosphonate pamidronate. In addition, pamidronate treatment increased total cellular protein, alkaline phosphatase activity, and type I collagen secretion in osteoblasts. Consistent with the above-mentioned findings, the rate of bone formation was also increased in osteoblasts cultured with pamidronate. The actions of two other bisphosphonates, the weak-acting etidronate and the potent new analogue zoledronate, were also compared with the action of pamidronate on proliferation of immortalized human fetal osteoblast (hFOB) cells and rate of bone formation. Pamidronate and zoledronate decreased hFOB cell proliferation with equal potency, whereas etidronate decreased proliferation only at much higher concentrations. Studies comparing EDTA and etidronate indicate that etidronate may act indirectly on the hFOB cells by reducing free divalent ion concentrations, whereas pamidronate and zoledronate appear to act on the hFOB cells by a direct action. Both pamidronate and zoledronate increase hFOB cell bone formation, whereas no increase is observed with etidronate and EDTA. Taken together, these observations strongly suggest that treatment with pamidronate or zoledronate enhances the differentiation and bone-forming activities of osteoblasts.     

PTEN基因通过Akt-mTOR对乳腺癌细胞增殖与凋亡的影响

目的:探讨PTEN基因通过Akt-mTOR对乳腺癌细胞增殖与凋亡的影响。方法:人乳腺癌MDA-MB-231细胞随机分为两组:pcDNA3.0组与pcDNA3.0-PTEN组,分别转染pcDNA3.0质粒、pcDNA3.0-PTEN质粒2 μg,转染48 h收集细胞。采用CCK-8法检测细胞存活率,双染法检测细胞凋亡,Western-blot检测细胞蛋白表达。结果:pcDNA3.0-PTEN组的细胞存活率低于pcDNA3.0组,对比差异有统计学意义(P＜0.05)。与pcDNA3.0组对比,pcDNA3.0-PTEN组的细胞凋亡率显著上升,对比差异有统计学意义(P＜0.05)。pcDNA3.0-PTEN组的PTEN蛋白表达量高于pcDNA3.0组,Akt、mTOR蛋白表达量低于pcDNA3.0组,对比差异有统计学意义(P＜0.05)。结论:PTEN基因过表达可通过抑制Akt-mTOR信号通路,提高乳腺癌细胞凋亡指数,降低细胞增殖活性,从而发挥抑癌作用。     

Type I insulin-like growth factor receptor function in breast cancer

Experimental evidence suggests an important role of the type I IGF receptor (IGF-IR) in breast cancer development. Breast tumors and breast cancer cell lines express the IGF-IR. IGF-IR levels are higher in cancer cells than in normal breast tissue or in benign mammary tumors. The ligands of the IGF-IR are potent mitogens promoting monolayer and anchorage-independent growth of breast cancer cells. Interference with IGF-IR activation, expression, or signaling inhibits growth and induces apoptosis in breast cancer cells. In addition, recent studies established the involvement of the IGF-IR in the regulation of breast cancer cell motility and adhesion. We have demonstrated that in MCF-7 cells, overexpression of the IGF-IR promotes E-cadherin-dependent cell aggregation, which is associated with enhanced cell proliferation and prolonged survival in three-dimensional culture.The expression or function of the IGF-IR in breast cancer cells is modulated by different humoral factors, such as estrogen, progesterone, IGF-II, and interleukin-1. The IGF-IR and the estrogen receptor (ER) are usually co-expressed and the two signaling systems are engaged in a complex functional cross-talk controlling cell proliferation.Despite the convincing experimental evidence, the role of the IGF-IR in breast cancer etiology, especially in metastatic progression, is still not clear. The view emerging from cellular and animal studies is that abnormally high levels of IGF-IRs may contribute to the increase of tumor mass and/or aid tumor recurrence, by promoting proliferation, cell survival, and cell-cell interactions. However, in breast cancer, except for the well established correlation with ER status, the associations of the IGF-IR with other prognostic parameters are still insufficiently documented.     

Type 1 receptor parathyroid hormone (PTH1R) influences breast cancer cell proliferation and apoptosis induced by high levels of glucose

Increased breast cancer incidence parallels the increase in cases of type 2 diabetes. We investigated the effect of type 1 receptor parathyroid hormone (PTH1R) expression on viability and apoptosis of breast cancer cells exposed to high levels of glucose. Upregulation of PTH1R was detected in patients with invasive ductal carcinoma of the breast and diabetes. In vitro, PTH1R silencing suppressed cell proliferation and apoptosis induced by high levels of glucose by regulating Bax/Bcl-2 expression. These results suggest PTH1R silencing may represent a novel treatment approach for patients diagnosed with invasive ductal carcinoma of the breast who are also managing diabetes.     

长链非编码RNA BDNF-AS在乳腺癌中的表达及作用

  目的  探讨长链非编码RNA（long non-coding RNA,lncRNA）脑源性神经营养因子（brain-derived neurotrophic factor,BDNF）-AS在乳腺癌组织和细胞系中的表达及其对乳腺癌癌细胞增殖、凋亡、迁移和侵袭的影响。  方法  收集2016年1月至2018年12月88例于兰州大学第一医院行乳腺癌手术切除患者的组织样本。RT-qPCR检测癌组织、癌旁组织、乳腺癌细胞系（MCF-7、MDA-MB-231、MDA-MB-468和SK-BR-3）及正常乳腺细胞HBL-100中lncRNA BDNF-AS的表达并分析其与临床特征的相关性。MDA-MB-231细胞经pcDNA3.1质粒过表达lncRNA BDNF-AS,使用MTT法检测细胞活性,EdU实验检测细胞增殖能力,比色法检测Caspase-3活性;Western blot检测凋亡相关蛋白（Bax、Bcl-2）、侵袭转移相关蛋白（MMP-9、E-cadherin）和BDNF蛋白表达,划痕实验和Transwell实验检测细胞迁移和侵袭。  结果  lncRNA BDNF-AS在乳腺癌组织（P < 0.05）和乳腺癌细胞中表达显著降低（P < 0.01）。乳腺癌组织中的lncRNA BDNF-AS表达与患者TNM分期（P < 0.05）和淋巴结转移（P < 0.05）呈负相关。lncRNABDNF-AS过表达可降低MDA-MB-231细胞活性（P < 0.01）、EdU检测的阳性细胞数（P < 0.01）、Caspase-3活性（P < 0.01）,下调Bcl-2蛋白和上调Bax蛋白表达（P < 0.01）。lncRNA BDNF-AS过表达可抑制划痕愈合和细胞侵袭（P < 0.01）,下调MMP-9蛋白和上调Ecadherin蛋白表达（P < 0.01）及下调BDNF mRNA和蛋白的表达。  结论  在乳腺癌中lncRNA BDNF-AS表达下调,BDNF-AS抑制乳腺癌细胞增殖、迁移和侵袭,并促进凋亡。      

miR-139-5p通过调节Notch信号通路对乳腺癌细胞增殖和凋亡的影响

目的:探讨miR-139-5p通过靶向抑制Notch信号通路调控乳腺癌细胞的增殖和凋亡。方法:通过实时定量PCR法检测miR-139-5p以及Notch1在乳腺癌和乳腺上皮细胞中的表达;采用双荧光素酶报告基因法验证miR-139-5p对Notch1的调控作用;通过CCK8和流式细胞术分别检测miR-139-5p与Notch1对乳腺癌细胞MDA-MB-231增殖和凋亡的影响,并通过Western blot法检测miR-139-5p对Notch1及相关凋亡蛋白表达的影响。结果:miR-139-5p在人乳腺癌细胞中表达显著下调（P<0.05）,尤其在乳腺癌MDA-MB-231细胞中下调更为显著（P<0.01）;双荧光素酶报告基因实验证实miR-139-5p能与Notch1 3’ UTR结合;同时miR-139-5p过表达能够显著抑制细胞活力,促进细胞凋亡（P<0.01）,显著抑制Notch1蛋白表达（P<0.01）,进而降低相关凋亡蛋白Bcl-2的表达,增强Bax的表达。 结论:miR-139-5p能够通过抑制靶基因Notch1的表达,抑制乳腺癌细胞的增殖,促进细胞凋亡。     

ZIC1联合苦参碱对人乳腺癌 MDA - MB -231细胞增殖、迁移及凋亡的影响

目的：探讨 ZIC1联合苦参碱对人乳腺癌 MDA - MB -231细胞的增殖、迁移能力及凋亡的影响。方法：将慢病毒载体 rLV - Zic1- PGK - puro 稳定转染人乳腺癌 MDA - MB -231细胞株并得到稳定传代的细胞株,Western blot 法检测转染效果。以人乳腺癌 MDA - MB -231细胞及 ZIC1基因稳定转染的细胞为研究对象进行药物实验,MTT 法筛选出苦参碱的半数抑制浓度（IC50）后分组,划分 A 空载不加药组（阴性对照组）,B空载加药组,C 转染不加药组和 D 转染加药组。对四组细胞采用黏附试验检测细胞黏附（增殖）能力、划痕实验检测细胞迁移能力、流式细胞术检测细胞凋亡。结果：ZIC1或苦参碱单独作用均可抑制乳腺癌 MDA - MB-231细胞黏附（增殖）、迁移及增强其凋亡,差异较对照组有统计学意义（P <0.05）,且在抑制细胞迁移上存在时间依赖性。两者联合作用抗癌效果更明显,差异较其它三组有统计学意义（P <0.05）。结论：苦参碱联合 ZIC1可明显增强对人乳腺癌 MDA - MB -231细胞的抑癌效果。