王志,黄建军
WANG Zhi1,HUANG Jianjun2 (1.Department of General Surgery

• 1:安顺市人民医院普外科
• 2:贵阳医学院附院乳腺外科

摘要(Abstract)：

目的:探讨新辅助化疗对乳腺癌ER、PR、P-gp、GST-π表达的影响。方法:采用免疫组织化学法检测91例乳腺癌患者在新辅助化疗前后乳腺癌灶组织ER、PR、P-gp、GST-π的表达。结果:新辅助化疗前后ER有9例由阳性转为阴性,6例由阴性转阳性,P>0.05;PR有9例由阳性转为阴性,有11例由阴性转为阳性,P>0.05;P-gp在化疗前后的阳性表达率分别为41.75%和64.83%,差异有统计意义(P<0.05);GST-π在化疗前后的阳性表达率分别为49.45%和54.94%,差异无统计意义(P>0.05)。结论:新辅助化疗对乳腺癌组织ER、PR表达状态无显著影响;新辅助化疗后P-gp表达显著升高,对乳腺癌新辅助化疗疗效有一定预测价值。
Objective:To study the effects of neoadjuvant chemotherapy on expression of ER,PR,P-glycoprotein(P-gp) and Glutathione S-transferase Pi(GST-π) in breast cancer.Methods:Immunohistochemistry method was adopted to measure the expressions of ER,PR,P-gp and GST-π in 100 patients with breast cancer before and after neoadjuvant chemotherapy.Results:The status of ER and PR changed in 15 and 20 cases respectively;and there was no significant difference before and after neoadjuvant chemotherapy.The positive rate of P-gp before and after chemotherapy were 41.75% and 64.83% respectively,and the difference was statistically significant(P<0.05).The positive rates of GST-π before and after chemotherapy were 49.45% and 54.94% respectively,and no significant difference was found between them(P>0.05).Conclusions:Neoadjuvant chemotherapy has no significant influence on status of ER and PR.The expression of P-gp increased significantly after neoadiuvant chemotherapy.It suggests that P-gp could be used for prediction of therapeutic efficacy of neoadiuvant chemotherapy.

关键词(KeyWords)： 乳腺肿瘤;化学疗法,辅助;多药耐药相关蛋白类;谷胱甘肽转移酶
breast neoplasms;chemotherapy,adjuvant;multidrug resistance-associated proteins;glutathione transferase

Abstract:

Keywords:

基金项目(Foundation): 贵州省卫生厅基金项目:黔卫发[2007]119号

作者(Author): 王志,黄建军
WANG Zhi1,HUANG Jianjun2 (1.Department of General Surgery

DOI: 10.19367/j.cnki.1000-2707.2011.04.005

参考文献(References)：

• [1]Deo SV,BhutaniM,Shukla NK,et al.Randomized trialcomparing neo-adjuvant versus adjuvant chemotherapy inoperable locally advanced breastcancer(T4b N 0-2 M 0)[J].J Surg Oncol,2003(4):192-197.
• [2]Ganem G,Tubiana-Hulin M,Fumoleau P,et al.PhaseⅡtrial com-bining docetaxel and doxorubicin as neoadjuvantchemotherapy in patients with operable breast cancer[J].A nn Oncol,2003(11):1623-1628.
• [3]沈镇宙,邵志敏.现代乳腺肿瘤学进展[M].上海:上海科学技术文献出版社,2002:87-91,387-392.
• [4]杨学宁,吴一龙.实体瘤治疗疗效评价标准—RECIST[J].循证医学,2004(2):85-90,111.
• [5]Faneyte,IF Kristel,PM van-de-Vijver,et al.Determiningmdr1/P-glycoprotein expression in breast cancer[J].InterJ Cancer,2001(1):114-122.
• [6]Susan H,Lee MD,Maureen A,et al.The effect of neoadju-vant chemotherapy on estrogen and progesterone receptorexpression and hormone receptor status in breast cancer[J].Am J Surg,2003(4):348-350.
• [7]Faneyte IF,Schrama JG,Peterse JL,et al.Breast cancerresponse to neoadjuvant chemotherapy:predictive markersand relation with outcome[J].British journal of Cancer,2003(3):406-412.
• [8]Piper GL,Patel NA,Malay MB,et al.Neoadjuvant chemo-therapy for locally advanced breast cancer results in altera-tions in preoperative tumor marker status[J].Am J Surg,2004(12):1103-1106.
• [9]MacGrogan G,Mauriac L,Durand M,et al.Primary chem-otherapy in breast invasive carcinoma:predictive value ofthe immunohisto-chemical of hormona receptors,p53,c-erbB-2,MiB1,pS2 and GSTπ[J].British Cancer,1996(9):1458-1465.
• [10]费伯健,周士福,金留根,等.新辅助化疗对乳腺癌激素受体表达和状态的影响[J].南京医科大学学报(自然科学版),2005(11):772-774.
• [11]Burger H,Foekens JA,Look MP,et al.RNA expressionof breast cancer resiatance protein,lung resistance-relat-ed protein,multidrug resistance-associated protein 1 and2,and multidrug resistance gene 1 in breast cancer.Cor-relation with chemotherapeutic response[J].Clin CancerRes,2003(2):827.
• [12]王立梅,毛慧生,林晓萍,等.耐药基因MDR1、GST-π在乳腺癌组织中的表达及临床应用[J].中国肿瘤临床,2000(11):846-847.

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