术前化疗诱导乳腺癌细胞凋亡的临床意义

目的 研究乳腺癌术前化疗是否能引起肿瘤细胞的细胞凋亡，以及肿瘤细胞凋亡的改变是否和术前化疗的疗效及生存率有关。方法 应用原位杂交和免疫组化法，检测术前化疗和对照肝瘤细胞的凋亡指数（ＡＩ）和肿瘤铁雌激纱受体状态，采用学生检验法（ｔａｉｌｅｄｓｔｕｄｅｎｔ‘ｓ ｔ－ｔｅｓｅ）。比较术前化疗组和对照组ＡＩ的差要用ａｐｌａｎ－Ｍｅｉｅｒ方法，计算术前化疗组和对照组的总生存率（ＯＳ）和无病生存率（ＲＦＳ）

Clinical implication of apoptosis of breast cancer induced by preoperative chemotherapy

OBJECTIVE: To investigate whether apoptosis could be induced by preoperative chemotherapy in breast cancer patients, and determine if it is correlated with clinical response and patients' survival. METHODS: Apoptosis was assayed by in situ DNA end labeling and receptors for estrogen and progesterone were examined immunohistochemically. Comparison of the differences in apoptotic index (AI) and clinical response was made between patients received preoperative chemotherapy and those did not, using the one tailed Student's t-test. The Kaplan-Meier method was utilized to calculate relapse-free and overall survival time. Cox proportional hazards model was used to conduct multivariate analysis of prognostic factors and differences in overall survival and relapse-free survival after adjustment for other variables. RESULTS: Apoptosis was induced by preoperative chemotherapy, especially in lymph node positive patients. Post-chemotherapy AI correlated with better clinical response and increased patient survival, including relapse (disease) free survival and overall survival. CONCLUSION: The extent of apoptosis induced by preoperative chemotherapy of primary breast cancer may possibly predict an individual patient's overall response to treatment.