Bcl-2、C-erbB2和PCNA表达与乳腺癌新辅助治疗疗效关系的研究

目的探讨Bcl-2、C-erbB2和PCNA作为浸润性乳腺癌新辅助治疗预后指标的可行性。方法选择55例接受新辅助治疗的乳腺癌病例,空芯针穿刺标本及化疗后根治标本分别行S-P法免疫组织化学染色。所有病例均接受3~4周期含蒽环类化疗药的联合化疗,肿瘤缩小率用彩色多谱勒超声评估。结果术前化疗有效率(CR PR)为61.8%(34/55),完全缓解率(CR)为9.1%(5/55)。C-erbB2在分化较差、受体阴性病例中高表达(P<0.05)。CerbB2阴性病例肿瘤缩小明显,与C-erbB2表达阳性病例相比,差异有显著性(P<0.01)。PCNA在组织学高分级肿瘤中表达增高(P<0.05),化疗后PCNA表达减弱。Bcl-2表达在化疗前后及与各临床病理因素间比较中差异无显著性(P>0.05)。结论C-erbB2与PCNA可作为预测乳腺癌化疗疗效的有价值的指标。

Relationship between Bcl-2, CerbB2, PCNA expression and the antitumor efficacy of neoadjuvant chemotherapy in breast cancer

Objective To evaluate the feasibility of Bcl-2,CerbB2 and PCNA as prognostic indicators for neoadjuvant chemotherapy in invasive breast cancer.Methods Fifty-five patients underwent core needle biopsy before neoadjuvant chemotherapy.S-P immunohistochemical staining was used to detect the expression of Bcl-2,CerbB2 and PCNA in both biopsy and operation specimens.All patients received three to four courses of anthracycline-based chemotherapy.Tumor reduction rate was assessed by color ultrasound.Results The effective rate(CR PR)for neoadjuvant chemotherapy was 61.8%(34/55),complete remission rate(CR)was 9.1%(5/55).CerbB2 was overexpressed in patients with poor differentiation and estrogen receptors negative(P<0.05).Tumor was decreased in size significantly in patients with CerbB2 negative expression as compared with that in patients with positive expression(P<0.01).The expression of PCNA was increased in patients with high histological grade(P<0.05)and its expression was decreased after chemotherapy.Bcl-2 expression did not have remarkable changes after chemotherapy(P>0.05).Conclusions CerbB2 and PCNA might be valuable factors in predicting chemotherapy efficacy in breast cancer.