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目的探讨ET方案新辅助化疗对乳腺癌组织中CXCR4表达的影响及临床意义。方法回顾性分析我院2005年4月至2009年3月期间59例接受3周期ET(紫杉醇+表阿霉素)方案新辅助化疗的Ⅱ期、Ⅲ期乳腺癌患者的临床资料,应用免疫组化方法检测乳腺癌组织中CXCR4的表达情况,分析其与临床病理特征的关系。结果 CXCR4在乳腺癌组织中的表达阳性率为94.9%(56/59),在癌旁正常组织中不表达。CXCR4表达水平与淋巴结转移(P=0.019)及肿瘤TNM分期有关(P=0.040),与患者年龄、肿瘤大小、组织学分级、ER和PR状态以及HER2表型无关(P>0.05)。新辅助化疗后CXCR4表达水平下降,但CXCR4的表达水平及化疗后下降的比例与化疗疗效无关(P>0.05)。CXCR4的表达分布状态中呈簇状分布者化疗疗效好于呈散在分布者(P=0.015)。结论 ET方案新辅助化疗后乳腺癌组织中CXCR4的表达水平下降比例与化疗疗效无关,但其表达的分布状态可作为新辅助化疗疗效的参考指标。
Objective To investigate the effect and clinical significance of ET regimen neoadjuvant chemotherapy on CXCR4 expression in breast cancer tissues. Methods The clinical data of 59 patients with stage Ⅱ and stage Ⅲ breast cancer who underwent neoadjuvant chemotherapy with 3 cycles of ET (paclitaxel + epirubicin) regimen from April 2005 to March 2009 in our hospital were analyzed retrospectively. The detection of CXCR4 expression in breast cancer tissues and its relationship with clinicopathological features. Results The positive rate of CXCR4 expression in breast cancer tissues was 94.9% (56/59), which was not expressed in adjacent normal tissues. The expression of CXCR4 was correlated with lymph node metastasis (P = 0.019) and tumor TNM stage (P = 0.040), but not with age, tumor size, histological grade, ER and PR status and HER2 phenotype (P> 0.05). The expression of CXCR4 decreased after neoadjuvant chemotherapy, but the expression level of CXCR4 and the decreased ratio after chemotherapy had no relation with the curative effect of chemotherapy (P> 0.05). The distribution of CXCR4 in the cluster distribution of chemotherapy is better than scattered distribution (P = 0.015). Conclusion The decreased proportion of CXCR4 expression in breast cancer tissues after neoadjuvant chemotherapy is not related to the efficacy of chemotherapy. However, the distribution of the expression of CXCR4 may be used as a reference index for the efficacy of neoadjuvant chemotherapy.