【摘要】 目的研究不同新辅助化疗方案对乳腺癌耐药表型的影响。方法用免疫组织化学方法检测同一乳腺癌病例新辅助化疗前后耐药基因多药耐药相关蛋白(MRP1)、谷胱甘肽-S-转移酶π(GST-π)及拓扑异构酶Ⅱ(TOPO-Ⅱ)的表达情况,探讨三种化疗方案即VCF方案(VCR+CTX+5- FU),CEF方案(CTX+EPI+5-FU)和TEC方案(Docetaxol+EPI+CTX)对耐药基因表达的影响,比较化疗前后耐药基因表达的差异。结果VCF方案对乳腺癌耐药表型的影响最大,该组22例中有 8例经新辅助化疗后GST-π由阴性转为阳性表达,6例化疗后TOPO-Ⅱ表达转阴,化疗前后差异显著 (P<0．05);CEF方案组13例中,有4例经化疗后TOPO-Ⅱ由阳性转为阴性表达,4例化疗后GST-π表达转阳。TEC方案对乳腺癌耐药表型的影响最小,但该方案组11例中有3例经化疗后MRP1由阳性转为阴性表达。结论不同化疗方案的乳腺癌新辅助化疗对耐药基因表达的影响存在差异。更多还原

【Abstract】 Objective To investigate the influence of different neoadjuvant chemotherapeutic regimens on drug resistance phenotype of breast carcinoma. Methods Immunohistochemical study was carried out on pre-treatment biopsy specimens and surgical specimens from the individual breast carcinoma patients to detect the expression of three drug resistance genes: multidrug resistance associated protein ( MRP1 ) , glutathione-S-transferase pi ( GST-π ) and topoinsomerase Ⅱ ( TOPO- Ⅱ ) , under three chemotherapeutic regimens (VCF, CEF and TEC). Results VCF regimen was the most powerful. In 22 GST-π negative cases, 8 cases turned to positive (P < 0. 05). Prechemotherapy positive TOPO- Ⅱ expression turned to negative in 6 cases (P < 0. 05 ). In CEF regimen group ( 13 cases) , positive TOPO- Ⅱ expression turned to negative in 4 cases. Negative GST-π expression turned to positive in 4 cases. TEC regimen had the least influence on drug resistance phenotype, with MRP1 expression turning to negative in 3 cases. Conclusion Different neoadjuvant chemotherapy regimen for breast carcinoma alters the expression of drug resistance genes with varied extent.更多还原