【摘要】 目的探讨人表皮生长因子受体-2(Her-2)及拓扑异构酶Ⅱα(Topo-Ⅱα)与临床病理参数之间的关系,分析Her-2和Topo-Ⅱα表达在以蒽环类为基础的新辅助化疗中的临床意义。方法选择2016年1月~2017年10月就诊于潍坊市人民医院经肿物穿刺后确诊为浸润性乳腺癌的54例患者及其石蜡包埋组织。所有患者均进行了雌激素受体(ER)、孕激素受体(PR)、细胞增殖核抗原Ki-67(KI-67)、Her-2表达水平的检测。采用免疫组化方法检测Topo-Ⅱα的表达,观察不同治疗效果患者乳腺癌组织中Her-2及Topo-Ⅱα表达情况。结果 54例乳腺癌患者中,48例存在淋巴结转移,Her-2阳性率为88.9%,Topo-Ⅱα的阳性率为87.0%。Her-2的表达与患者年龄、肿瘤直径、肿瘤部位、腋窝淋巴结转移无关(P>0.05),与分期及基因亚型有关(r=-0.3、0.3,P<0.05)。Topo-Ⅱα的表达与年龄、肿瘤直径、肿瘤部位、腋窝淋巴结转移、分期、基因亚型无关(P>0.05),Topo-Ⅱα的表达与Her-2的表达呈正相关(r=0.7,P<0.05)。Her-2阴性患者客观有效率(ORR)为50.0%;阳性患者ORR为75.0%,差异有统计学意义(P<0.05)。Topo-Ⅱα阳性患者ORR为78.7%,阴性患者ORR为28.6%,差异有统计学意义(P<0.05)。Topo-Ⅱα和Her-2均为阳性患者的ORR为80.4%,Topo-Ⅱα和Her-2均为阴性患者ORR为20.0%,差异有统计学意义(P<0.05)。结论免疫组化检查Her-2和Topo-Ⅱα对于乳腺癌治疗具有重要指导意义,Topo-Ⅱα阳性可以有效改善蒽环类药物辅助治疗效果。Topo-Ⅱα及Her-2阳性的患者在新辅助化疗中可能有增敏效应。更多还原

【Abstract】 Objective To investigate the relationship between Her-2 and clinicopathological parameters and the relationship between Topo-Ⅱα and clinicopathological parameters, and analyze the clinical significance of Her-2 and Topo-Ⅱα expression in neoadjuvant chemotherapy based on anthracycline. Methods From January 2016 to October2017, 54 patients in Weifang People’s Hospital diagnosis of breast invasive cancer after underwent tumor puncture and their paraffin-embedded tissues were selected. The expression levels of ER, PR, KI-67, and Her-2 of all patients were detected. The expression of Topo-Ⅱα of all patients were detected by immunohistochemistry, the expression of Her-2 and Topo-Ⅱα in patients with different therapeutic effects was observed. Results Among the 54 patients, 48 patients had lymph node metastasis. The positive rate of Her-2 was 88.9%, and the positive rate of Topo-Ⅱα was 87.0%. Her-2 expression was not associated with age, size, location, axillary lymph node metastasis(P > 0.05), and was related to stage and genotype(r =-0.3, 0.3, P < 0.05). The expression of Topo-Ⅱα was not related to age, size, location, axillary lymph node metastasis, stage, or subtype(P > 0.05). The expression of Topo-Ⅱα was positively correlated with Her-2(r = 0.7, P < 0.05). The ORR of Her-2 negative patients was 50.0%; the ORR of Her-2 positive patients was 75.0%,the difference was statistically significant(P < 0.05). The ORR of Topo-Ⅱα positive patients was 78.7%, and the ORR of Topo-Ⅱα negative patients was 28.6%. The difference was statistically significant(P < 0.05). The ORR of patients with Topo-Ⅱα and Her-2 positive was 80.4%, and the ORR of patients with Topo-Ⅱα and Her-2 negative was 20.0%. The difference was statistically significant(P < 0.05). Conclusion Immunohistochemical examination of Her-2 and Topo-Ⅱα has important guiding significance for the treatment of breast cancer. Topo-Ⅱα positive expression can effectively improve the anthracycline-assisted treatment. Topo-Ⅱα and Her-2 may have sensitizing effect in neoadjuvant chemotherapy.更多还原