摘要
目的探讨表柔比星联合多西他赛新辅助化疗对乳腺癌患者癌组织Ki-67表达的影响及意义。方法选择行乳腺癌根治术的乳腺癌患者86例,术前均予表柔比星联合多西他赛新辅助化疗。化疗前及化疗后采用定量PCR法及Western blotting法检测癌组织(化疗前取穿刺活检组织,化疗后取手术切除组织)Ki-67 mRNA及蛋白表达。术后随访5年,采用Kaplan Meire生存曲线法统计无病生存期(DFS)、总生存期(OS),采用Cox比例风险回归模型分析DFS、OS与乳腺癌组织Ki-67表达的关系。结果化疗后乳腺癌组织Ki-67 mRNA及蛋白表达较化疗前均降低(P均<0.05)。根据化疗前后Ki-67 mRNA表达的变化量,以下调10%为临界值,86例患者中Ki-67mRNA下调≥10%者57例、下调<10%者39例,其DFS分别为36、22个月,OS分别为45、37个月,二者比较P均<0.01。乳腺癌组织Ki-67表达是乳腺癌患者DFS和OS独立影响因素(HR分别为1.807、1.768,P均<0.05)。结论表柔比星联合多西他赛新辅助化疗可下调乳腺癌患者癌组织Ki-67表达,而Ki-67表达与患者预后有关。
Objective To investigate the effect of neoadjuvant chemotherapy with epirubicin and docetaxel on Ki-67 expression in patients with breast cancer and its significance. Methods Eighty-six cases of patients with breast cancer treated with breast cancer radical surgery were selected in this study, epirubiein combined with docetaxel neoadjuvant chemotherapy were carried out before operation. Quantitative PCR and Western blotting were used to detect the expression of Ki-67 mRNA and protein before and after chemotherapy. After 5-year follow-up, we used Kaplan-meire survival curve method to analyze disease-free survival (DFS) and overall survival (OS) , used Cox proportional hazard regression model to analyze the relationship between DFS, OS and Ki-67 expression. Results The expression of Ki-67 mRNA and Ki-67 pro- tein in the breast cancer after chemotherapy were lower than that before chemotherapy ( all P 〈 0.05 ). According to Ki-67 mRNA expression changes, patients were further divided into higher change group (down-regulation of Ki-67 mRNA was more than or equal to 10% , 57 cases) and lower change group (Ki-67 mRNA reduced less than 10% , 39 cases). DFS of the two groups (higher and lower changes group respectively) was 36, 22 months and OS was 37, 45 months, and there were significant differences between the two groups ( all P 〈 0.01 ). Ki-67 was the an independent influencing factor for DFS and OS in patients with breast cancer ( HR were 1. 807, 1. 768, all P 〈 0.05 ). Conclusion Epirubiein and docetax- el neoadjuvant ehemotherapy can down-regulate the expression of Ki-67 in tumor tissues of patients with breast cancer, and the high expression of Ki-67 is related to the poor prognosis.
出处
《山东医药》
CAS
北大核心
2016年第24期63-65,共3页
Shandong Medical Journal