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目的 探讨术前经动脉灌注化疗治疗晚期乳腺癌的临床预后意义 ,同时研究其对乳腺癌细胞凋亡的影响及其可能的分子生物学机制。 方法 女性原发局部晚期乳腺癌 82例 ,分为术前经动脉灌注化疗 (CAP方案 )组 4 2例 ,对照组(未行化疗直接手术 ) 4 0例 ;术后密切随访 ,观察两组术后 5年无瘤生存率的差异。同时运用免疫组织化学 SP方法检测82例乳腺癌手术标本中的凋亡相关基因 Bcl- 2 ,Bax的表达状况 ,原位杂交检测细胞凋亡指数的变化 ,观察它们与乳腺癌浸润转移等生物学行为的关系及术前动脉灌注化疗的影响。数据予 SPSS10 .0统计学软件分析。 结果 (1)动脉灌注化疗治疗晚期乳腺癌的临床预后意义术前动脉灌注化疗组的 5年生存率达 6 1.9% ,而对照组的 5年生存率仅为30 % ,经 Kaplan- m eir生存分析提示有统计学显著性差异 (P<0 .0 5 )。(2 ) Bcl- 2表达及临床预后意义 Bcl- 2在乳腺癌中的表达率为 6 7.5 % ,Bax在乳腺癌中的表达率为 5 7.5 % ;Bcl- 2与乳腺癌的组织分化程度成正相关 (P<0 .0 5 ) ,与淋巴结转移正相关 (P<0 .0 5 ) ,对照组中 Bcl- 2高表达的乳腺癌 5年生存率低于低表达组 (P<0 .0 5 )。(3) Bax在乳腺癌中的表达及临床预后意义 Bax与淋巴结转移负相关 (P<0 .0 5 ) ,与组织分化无明显关系 ,?
Objective To investigate the clinical prognostic significance of preoperative arterial infusion chemotherapy in the treatment of advanced breast cancer and to study its effect on the apoptosis of breast cancer cells and its possible molecular biological mechanism. Methods Eighty-two patients with locally advanced breast cancer were divided into two groups: 42 cases in the CAP group and 40 cases in the control group (no chemotherapy and direct operation). The patients were followed up and the two groups were observed Five years after the tumor-free survival difference. At the same time, immunohistochemical SP method was used to detect the expression of apoptosis-related genes Bcl-2 and Bax in 82 cases of breast cancer. The changes of apoptotic index were detected by in situ hybridization, and their correlation with invasion and metastasis of breast cancer Behavioral Relationship and the Effect of Preoperative Arterial Infusion Chemotherapy. Data to SPSS10 .0 statistical software analysis. Results (1) The clinical prognostic significance of arterial infusion chemotherapy in the treatment of advanced breast cancer The 5-year survival rate of preoperative arterial infusion chemotherapy group was 6 1.9%, while the 5-year survival rate of the control group was only 30%, and survived by Kaplan-Meir Analysis showed statistically significant differences (P <0. 05). (2) The expression of Bcl-2 and clinical prognostic significance The expression of Bcl-2 in breast cancer was 6 7.5% and that of Bax in breast cancer was 5 7.5%. The degree of tissue differentiation of Bcl-2 and breast cancer was positive (P <0.05), and positive correlation with lymph node metastasis (P <0.05). The 5-year survival rate of Bcl-2 overexpressing breast cancer in the control group was lower than that in the low expression group (P <0. 5). (3) The expression of Bax in breast cancer and its clinical prognostic significance There was a negative correlation between the expression of Bax and lymph node metastasis (P <0.05), but not with tissue differentiation.