新辅助化疗后乳腺癌组织中cerbB-2、CXCR4和ER-α蛋白表达变化及其意义

目的探讨新辅助化疗对乳腺癌分子生物学指标cerbB-2、CXCR4、ER-α蛋白表达的影响及其可能的作用机制。方法利用48例乳腺癌患者新辅助化疗前粗针穿刺标本和新辅助化疗后手术标本,采用免疫组化检测化疗前、后乳腺癌组织cerbB-2、CXCR4、ER-α蛋白的表达变化;对新辅助化疗疗效进行病理形态学评价,分析cerbB-2、CXCR4、ER-α蛋白的表达与病理形态学变化的相关性。结果 (1)新辅助化疗后会引起乳腺癌组织cerbB-2、CXCR4等表达降低;(2)新辅助化疗引起乳腺癌cerbB-2和CXCR4降低与其病理变化存在相关性;而ER-α蛋白表达降低与新辅助化疗引起的病理变化无相关性;(3)新辅助化疗前乳腺癌组织cerbB-2和CXCR4表达呈正相关性。结论新辅助化疗导致乳腺癌组织中cerbB-2、CXCR4表达降低可能是蒽环类和紫杉醇为主的乳腺癌治疗的一个新的重要机制。另外新辅助化疗导致乳腺癌组织中cerbB-2、CXCR4表达降低可以作为评估乳腺癌新辅助化疗效果敏感的生物学指标。新辅助化疗会引起乳腺癌一系列分子复杂的、相关的变化。

Preliminary study of molecular indexes in breast cancer to evaluate the effect of chemotherapy

Aim To study the influence of neoadjuvant therapy on molecular markers of breast cancer：cerbB-2,CXCR4 and ER-α and the possible mechanism.Methods 48 patients with breast cancer were measured by using needle core biopsy in prechemotherapy and postchemotherapy（at the time of surgery）tumor specimens.The relationship between change expression of cerbB-2,CXCR4 in specimen with pathological change were compared.Results Analyzed by immunohistochemistry（IHC）on full tissue sections,cerbB-2 and CXCR4 level was down-regulated after the neoadjuvant chemotherapy on full tissue sections.Change expression of cerbB-2 and CXCR4 in specimen tended to be correlated with pathological change to the neoadjuvant chemotherapy on full tissue sections.No correlation was observed between change expression of ER-α in specimen with pathological response to the neoadjuvant chemotherapy.Conclusion A significant correlation between pretreatment levels of cerbB-2 and those of CXCR4 were observed.Our results suggested that after treatment with neoadjuvant systemic therapy,expressions of the cerbB-2,ER-α and CXCR4 were decreaced.These objective markers may be useful in evaluating the clinical response of neoadjuvant chemotherapy and selecting chemotherapy regimen for postoperative chemotherapy in breast cancer.