β3-微管蛋白及tau蛋白的表达在乳腺癌紫杉类药物化疗耐药中的预测价值  

Study on predictive role of β3-tubulin and tau with response to taxane-containing chemotherapy in breast cancer patients

作　　者：项友群[1] 季倩青 胡孝渠[1] 张虎祥[2] 黄督平[1] 李权[1] 瞿金妙[1] 万丽[2] 潘贻飞[1] 张筱骅[1] 郭贵龙[1] 

机构地区：[1]温州医科大学附属第一医院肿瘤外科,浙江温州325015 [2]温州医科大学附属第一医院病理科,浙江温州325015

出　　处：《温州医学院学报》2014年第7期498-502,507,共6页Journal of Wenzhou Medical College

基　　金：温州市科技计划资助项目(Y20090080)

摘　　要：目的：探讨乳腺癌β3-微管蛋白及微管相关蛋白tau的表达与紫杉类药物化疗耐药的相关性.方法：对48例进展期乳腺癌患者采用含紫杉类药物化疗方案进行2～6个周期新辅助化疗,应用空芯针穿刺技术获取化疗前及化疗后的第2、第4、第6周期末乳腺癌组织标本.免疫组织化学法分别检测β3-微管蛋白及tau蛋白的表达水平,探讨化疗疗效与β3-微管蛋白及tau蛋白表达的相关性.结果：化疗前β3-微管蛋白的平均表达率为45.6％±33.3％,tau蛋白平均表达率为62.9％±24.3％,化疗总体有效率为60.4％.β3-微管蛋白表达与紫杉类药物化疗有效率呈负相关,在化疗的第2、第4、第6疗程末,β3-微管蛋白的平均表达率分别为51.6％±31.2％,54.6％±29.1％,57.8％士30.4％,表达呈上升趋势,并在第4疗程获得了统计学的差异.tau蛋白表达与雌激素受体表达存在正相关,与化疗有效率之间无显著相关.tau在化疗前后表达无显著改变.结论：β3-微管蛋白是良好的紫杉类化疗敏感性预测因子,并且可能是紫杉类继发耐药发生的重要原因,在化疗前及化疗过程中检测其表达情况有助于化疗方案的选择.tau蛋白可能并不是一个良好的紫杉类化疗敏感性预测因子.Objective： The objective of this study was to explore the relationship between β3-tubulin and tau expression and resistance to the chemotherapy drug taxane in breast cancer patients. Methoas： A total of 48 breast cancer patients received 2 - 6 cycles of taxane-containing chemotherapy; β3-tubulin and tau expression was tested before chemotherapy and at the end of cycles 2, 4 and 6. The correlation between the efficacy of the chemotherapy and B3-tubulin and tau expression, as well as changes in β3-tubulin and tau expression over the course of chemotherapy, was examined. Results： The average expression rate of β3-tubulin before chemotherapy was 45.6% ± 33.3%. The overall response rate of the taxane-containing chemotherapy was 60.4%. β3-tubulin protein expression was significantly and negatively correlated with the response rate. At the end of cycles 2, 4 and 6 during the treatment course, the average expression rates of β3-tubulin were 51.6% ± 31.2%, 54.6% ± 29.1% and 57.8% ± 30.4%, respectively, showing an increasing trend, with the, β3-tubulin expression level at the end of cycle 4 being significantly different from that before chemotherapy. Tan protein showed positive correlation with the expression of ER, but has no correlation with the expression of β3-tubulin, also was no correlation with the sensitivity to taxane. Conclusion： β3-tubulin is a good predictor of chemosensitivity to taxane-containing drugs. Over the course of chemotherapy, β3-tubulin expression shows an upward trend, possibly being an important cause of secondary resistance to taxane-containing drugs. Detection of β3-tubulin expression before and throughout the chemotherapy will help with selection of the chemotherapy treatment plan. Tau protein may not be a good predictor of taxane chemotherapy, but may be a candidate for the prediction of hormone therapy sensitivity.

关 键 词：乳腺肿瘤 紫杉醇 微管蛋白 微管相关蛋白 免疫组织化学 

分 类 号：R737.9[医药卫生—肿瘤]