乳腺癌术前短期化疗对P糖蛋白表达影响.docVIP

乳腺癌术前短期化疗对P-糖蛋白表达的影响 　　摘 要 目的：观察乳腺癌患者术前短期化疗对肿瘤细胞中P -糖蛋白（P-gp）以及相关因子表达的调节，并探讨其临床意义。方法：选择2002―2007年40例乳腺浸润性导管癌患者，均经紫杉醇和表阿霉素治疗后行改良根治术。对手术标本进行HE染色，比较患者化疗前、后肿瘤大小、组织形态学变化及局部淋巴结转移情况。采用免疫组化法检测P-gp及相关因子[表皮生长因子受体（EGFR）、C-erbB-2、CD147、Ki67）表达。结果：化疗后，40例患者中10例出现大量炎性细胞浸润，4例有大片肿瘤组织坏死，肿瘤间质胶原纤维弥漫增生，肿瘤细胞密度减少，散在分布。化疗前、后P-gp阳性率分别为35.0%和60.0%（P0.05），EGFR阳性率分别为42.5%和80.0%（P0.01）；化疗后C-erbB-2、CD147、Ki67阳性率均较化疗前明显下降。EGFR、P-gp和C-erbB-2表达与临床分期、肿瘤大小、细胞核分级无关；化疗前P-gp表达与EGFR、C-erbB-2和CD147无明显相关性。结论：乳腺癌术前短期化疗可有效杀伤肿瘤细胞，诱导EGFR表达增强，但并不引起CD147等会导致肿瘤转移的下游因子表达，提示在肿瘤进展中肿瘤细胞的原发性耐药与其侵袭力可能并无关联。 　　关键词 乳腺癌 P -糖蛋白 表皮生长因子受体 化疗 　　中图分类号：R737.9 文献标志码：A 文章编号：1006-1533（2016）10-0006-05 　　The effect of short-term chemotherapy preoperatively on P-glycoprotein expression in breast cancer 　　BAO Yun， LI Qiong， TANG Feng 　　（Department of Pathology， Huashan Hospital， Fudan University， Shanghai 200040， China） 　　ABSTRACT Objective： To observe the effect of short-term chemotherapy preoperatively on the expression of P-glycoprotein（P-gp）and some related factors in patients with breast cancer and its clinical significance. Methods： Forty patients with invasive ductal breast cancer confirmed by biopsy were treated with paclitaxel and epirubicin for 2-3 courses followed by modified radical mastectomy from 2002 to 2007. The surgical specimens were stained using HE， and tumor size， histological changes， and the local lymph node metastasis were compaired before and after chemotherapy. The expressions of P-gp and some related factors of epidermal growth factor receptor（EGFR）， C-erbB-2， CD147 and Ki67 were assessed by immunohistochemistry. Results： After chemotherapy， a large number of inflammatory cell infiltration was found in 10 cases and necrosis in 4 cases. It showed that the collagen fibers were proliferated and the density of cancer cells was reduced and scattered. The positive rate was 35.0% and 60.0% in P-gp expression（P0.05）， and was 42.5% and 80.0% in EGFR expression befor and after chemotherapy（P 　　KEY WORDS breas