【摘要】 目的研究乳腺癌新辅助化疗前后TopoⅡα阳性表达及其对术后化疗方案选择的指导作用。方法对TNM分期Ⅱb及以上的乳腺癌患者行新辅助化疗治疗后,适合手术的患者行保乳手术治疗。免疫组化法测定新辅助化疗前后的TopoⅡα阳性表达,对比化疗前后、不同化疗方案化疗后的阳性表达情况,记录对比TopoⅡα阳性表达和阴性表达患者的术后疗效。结果CMF方案化疗前后的TopoⅡα阳性表达率差异无统计学意义(P>0.05);EC方案化疗后TopoⅡα阳性表达率显著高于化疗前(P<0.05),且显著高于CMF方案组(χ~2=4.219,P=0.040<0.05);ECT方案化疗后TopoⅡα阳性表达率显著高于化疗前(P<0.05),且显著高于CMF方案组(χ~2=6.522,P=0.011<0.05)。EC方案组和ECT方案组化疗后,TopoⅡα阳性表达无统计学差异(χ~2=0.269,P=0.604>0.05)。化疗前TopoⅡα阳性表达的患者,CR+PR率、中位TTF显著高于阴性表达的患者(P<0.05),腋窝淋巴结转移低于阴性表达的患者(P<0.05)。结论含蒽环类药物的化疗方案具有促进TopoⅡα阳性表达,提高术后疗效的作用,在术后辅助化疗方案中可以添加蒽环类药物,增加化疗敏感性。更多还原

【Abstract】 Objective To study the expression of TopoⅡαin breast cancer patients before and after neoadjuvant chemotherapy and its guiding significance in the selection of postoperative chemotherapy.Methods Breast cancer patients with stageⅡb and above were treated with neoadjuvant chemotherapy.Patients who suit for surgery were treated with breast conserving surgery.The expression of TopoⅡαbefore and after neoadjuvant chemotherapy were detected by immunohistochemistry.Compared the positive expression of TopoⅡαbefore and after neoadjuvant chemotherapy and the effect between patients with positive and negative expression of TopoⅡα.Results The expression of TopoⅡαin CMF regimen before and after chemotherapy was not statistically significant(P>0.05).The number of positive expression patients accepted EC chemotherapy was significantly higher than that before chemotherapy(P<0.05)and was significantly higher than that of CMF(χ~2=4.219,P=0.040<0.05).The number of positive expression patients accepted ECT chemotherapy was significantly higher than that before chemotherapy(χ~2=6.522,P=0.011<0.05).There was no significant difference between EC and ECT group in the positive expression of TopoⅡα(χ~2=0.269,P=0.604>0.05).The CR+PR rate,median TTF were significantly higher in patients with TopoⅡαpositive expression than those with negative expression(P<0.05),axillary lymph node metastasis was lower(P<0.05).ConclusionChemotherapy regimen containing anthracycline can increase the expression of TopoⅡαand improve the curative effect.The anthracyclines can be added to the postoperative adjuvant chemotherapy regimen to increase the chemosensitivity.更多还原