术前化疗诱导乳腺癌细胞凋亡的临床意义  

Clinical implication of apoptosis of breast cancer induced by preoperative chemotherapy

作　　者：邵志敏[1] 李俊[1] 吴炅[1] 陆劲松[1] 韩企夏[1] 沈镇宙[1] 

机构地区：[1]上海医科大学肿瘤医院乳腺外科,200032

出　　处：《中华肿瘤杂志》2000年第4期295-297,共3页Chinese Journal of Oncology

基　　金：国家自然科学基金项目 !(396 70 80 3) ;上海市卫生系统百人计划 !(98BR0 15 ) ;夏郦君女士科研基金项目资助

摘　　要：目的　研究乳腺癌术前化疗是否能引起肿瘤细胞的细胞凋亡 ,以及肿瘤细胞凋亡的改变是否和术前化疗的疗效及生存率有关。方法　应用原位杂交和免疫组化法 ,检测术前化疗和对照肿瘤细胞的细胞凋亡指数 (AI)和肿瘤细胞的雌激素受体状态 ;采用学生检验法 (tailedstudent′st test) ,比较术前化疗组和对照组AI的差别 ;采用Kaplan Meier方法 ,计算术前化疗组和对照组的总生存率(OS)和无病生存率 (RFS) ;CoxHazard模型用来计算不同指标的多因素分析。结果　提示了在乳腺癌中 ,特别是在淋巴结阳性的乳腺癌中 ,术前化疗能诱导肿瘤细胞的细胞凋亡 ,而术前化疗后的肿瘤细胞AI的高低和术前化疗的疗效以及患者的生存率密切相关。Objective To investigate whether apoptosis could be induced by preoperative chemotherapy in breast cancer patients, and determine if it is correlated with clinical response and patients′ survival.Methods Apoptosis was assayed by in situ DNA end labeling and receptors for estrogen and progesterone were examined immunohistochemically. Comparison of the differences in apoptotic index (AI) and clinical response was made between patients received preoperative chemotherapy and those did not, using the one tailed Student′s t test. The Kaplan Meier method was utilized to calculate relapse free and overall survival time. Cox proportional hazards model was used to conduct multivariate analysis of prognostic factors and differences in overall survival and relapse free survival after adjustment for other variables. Results Apoptosis was induced by preoperative chemotherapy, especially in lymph node positive patients. Post chemotherapy AI correlated with better clinical response and increased patient survival, including relapse (disease) free survival and overall survival.Conclusion The extent of apoptosis induced by preoperative chemotherapy of primary breast cancer may possibly predict an individual patient′s overall response to treatment.

关 键 词：乳腺癌 药物疗法 细胞凋亡 术前化疗 

分 类 号：R737.9[医药卫生—肿瘤]