乳腺癌相关生物学指标对紫杉类药物治疗晚期乳腺癌疗效预测作用分析  

Analysis of the predictive effect of marker for the clinical sensitivity of taxane in advanced breast cancer

作　　者：刘芳[1] 冯胜强[2] 孙军仲[1] 郝春芳[3] 张少华[3] 杨清明[1] 彭朝津[1] 

机构地区：[1]解放军总医院第一附属医院干部病房,北京100037 [2]总参谋部警卫局保健处,北京100017 [3]军事医学科学院解放军307医院乳腺科,北京100039

出　　处：《中华肿瘤防治杂志》2006年第9期685-688,共4页Chinese Journal of Cancer Prevention and Treatment

摘　　要：目的:回顾性研究雌激素受体(ER)、p53、bcl-2和mdr-1对乳腺癌应用紫杉类药物化疗疗效的预测作用。方法:182例晚期乳腺癌患者应用紫杉类化疗,其中单药紫杉醇组37例,单药泰索帝组22例,紫杉醇联合组78例,泰索帝联合组45例。应用免疫组化的方法对所有患者的ER、p53、bcl-2和mdr-1生物学指标在蛋白水平进行检测。结果:KPS评分、解救情况以及既往蒽环类及转移部位多少对紫杉类药物疗效均无预测作用。ER阳性患者有效率为33.01%(34/103),ER阴性患者有效率为50·63%(40/79),两组相比差异有统计学意义,χ2=5·755,P=0·022;而p53、bcl-2、mdr-1等阳性组与阴性组有效率之间相比,差异无统计学意义(p53χ2=0·004,P=0·950;bcl-2χ2=0·651,P=0·451;mdr-1χ2=0·177,P=0·751;)。多因素分析显示,ER阳性差异仍有统计学意义,P=0·027。而KPS评分、既往应用蒽环类药物、转移部位数目、差异均无统计学意义。结论:ER阴性对紫杉类药物的疗效可能有预测作用,而p53、bcl-2和mdr-1对紫杉类药物无预测作用。OBJECTIVE： To explore the correlation of ER, p53, bcl-2, mdr-1 with clinical taxane sensitivity in advanced breast cancer. METHODS：Among 182 patients with advanced breast cancer, 37 patients were paclitaxel used as a single agent, 22 patients were docetaxel used alone, 78 patients of paclitaxel were administered in combination with anthracylines, gemcitabine, and platins, and forty- five patients were adninistered with doeataxel combinations. ER, p53, bcl-2 and mdr-1 were assayed with immunohistochemistry. RESULTS：In univariate analysis, the RR in patients who had preciously received anthracylines or not and Karnofsky performance score （KPS）, metastatic sites and precious chemotherapy were of no statistic significance. The RR in ER positive arm and ER negative arm were 33. 1%（34/103）, and 50. 63%（40/79）, respectively, the difference was significant, X^2 = 5. 755 P= 0. 022. The difference was not significant in the positive arms and negative arms for p53, bcl-2, mdr- 1 （p53 X^2=0.004,P=0.950; bcl-2 2=0.651,P=0.451; mdr-1 X^2=0. 177,P=0.751）. Multivariate analysis showed that ER had significant difference, P= 0. 027. CONCLUSION： ER negative can be used as a response predictor of taxanes, whereas other biomarkers, such as mdr-1, p53 and bcl-2, can not be used as response predictors of taxanes.

关 键 词：乳腺肿瘤/药物疗法 紫杉酚 生物学标记/分析 

分 类 号：R737.9[医药卫生—肿瘤]