AC-T序贯化疗方案对三阴性乳腺癌患者乳腺癌耐药蛋白、P-糖蛋白表达的影响

目的 探究AC-T序贯化疗方案对三阴性乳腺癌患者乳腺癌耐药蛋白(BCRP/ABCG2)、P-糖蛋白(P-gp)表达的影响.方法 选取南通市妇幼保健院2012年3月至2013年3月收治的80例不可手术的分子分型为三阴性乳腺癌患者为观察对象,采用随机数字表法分成观察组(n=40)和对照组(n=40),观察组采用4个周期AC-T序贯化疗方案,对照组采用四个周期FAC化疗方案,两者化疗后均采用三维适形放射治疗,对两组化疗后的无病生存期(DFS)、总生存率(OS)及患者乳腺癌耐药蛋白、P-糖蛋白表达情况进行比较.结果 化疗期间观察组和对照组均出现1例患者死亡.化疗后,观察组患者1年、3年的DFS分别为92.5％、82.5％,对照组为87.5％、77.5％;观察组OS为87.5％,对照组为85.0％,组间比较差异均无统计学意义(P>0.05).观察组和对照组患者化疗前BCSCs微球体数目分别为(2±1)个和(2±1)个、直径为(112.3±4.5)μm和(113.3±4.0)μm,组间比较差异均无统计学意义(P>0.05);化疗后,观察组和对照组BCSCs微球体直径均较化疗前显著增大,分别为(259.7±5.8)μm和(261.3±5.9)μm,组内比较差异有统计学意义(P<0.05);而BCSCs微球体数目分别为(2±1)个和(2±1)个,组内比较差异无统计学意义(P>0.05).化疗前,两组患者BCSCs微球细胞ABCG2、P-gp、CD44+、CD24-蛋白表达比较差异均无统计学意义(P>0.05),化疗后两组患者ABCG2、P-gp、CD44+蛋白表达显著升高,CD24-蛋白表达显著降低,差异均有统计学意义(P<0.05),且观察组ABCG2、P-gp、CD44+蛋白表达显著低于对照组,CD24-蛋白表达显著低于对照组,差异具有统计学意义(P<0.05).结论 AC-T序贯化疗方案进行新辅助化疗治疗乳腺癌与FAC方案疗效相当,但出现肿瘤耐药程度轻于FAC化疗方案.AC-T序贯化疗方案治疗乳腺癌确实会下调癌细胞ABCG2、P-gp表达,从而减轻患者的耐药性.

Effect of AC-T sequential chemotherapy on the expression of triple-negative breast cancer resistance protein and P-gp in patients with breast cancer

Objective To explore the effect of AC-T sequential chemotherapy on the expression of d breast cancer resistance protein and P-gp in patients with breast cancer. Methods A total of 80 cases of triple-negative breast cancer patients, who treated in our hospital from March 2012 to March 2013, were selected and divided into the observa-tion group (n=40) and the control group (n=40) according to random number table method. The observation group was treated with four cycles of AC-T sequential chemotherapy, and the control group was treated with four cycles of FAC chemotherapy. The patients of the two groups were treated with three-dimensional conformal radiotherapy after chemo-therapy. The disease-free survival (DFS) and overall survival (OS) and the expression of ATP-binding cassette superfami-ly G (White) member 2 (ABCG2) and P-glycoprotein in breast cancer between the two groups after chemotherapy were compared. Results One patient in the observation group and one in the control group died during chemotherapy. After treatment, the DFS of the observation group and the control group in 1 year and 3 years were 92.5％and 82.5％, 87.5％and 77.5％, respectively. There was no significant difference between the observation group and the control group in OS (87.5％ vs 85.0％) (P>0.05). The numbers of microspheres of BCSCs microspheres in the observation group and the control group before chemotherapy were respectively (2 ± 1) and (2 ± 1), and the diameter were (112.3 ± 4.5) μm and (113.3±4.0)μm, with no statistically significant difference between the two groups (P<0.05). After chemotherapy, the di-ameters of microspheres in the observation group and the control group were (259.7 ± 5.8)μm and (261.3 ± 5.9)μm, re-spectively, which were significantly higher than those before chemotherapy (P<0.05);while BCSCs microspheres num-ber in the observation group and the control group were respectively (2+1) and (2+1), with no significant difference with-in the group (P>0.05). Before chemotherapy, there was no significant difference between the two groups in cells ABCG2 BCSCs microspheres, P-gp, CD44+, CD24-protein expression (P>0.05);after chemotherapy, the expression of ABCG2, P-gp and CD44+protein was significantly increased, and the expression of CD24-protein was significantly decreased in the two groups (P<0.05). Moreover, the protein expression of ABCG2, P-gp, CD44+and CD24-was significantly lower than the control group (P<0.05). Conclusion AC-T sequential therapy and FAC chemotherapy have the almost same curative effect, but the degree of tumor resistance was lighter than FAC chemotherapy. AC-T sequential chemotherapy do downregulate the expression of ABCG2 and P-gp in the treatment of patients with breast cancer resistance, thereby re-ducing the resistance of patients with breast cancer.