FOXP3^+Treg细胞对浸润性乳腺癌患者新辅助化疗疗效的预测价值分析  

The value of FOXP3^+ Treg cells in predicting the curative effect of neoadjuvant chemotherapy in patients with invasive breast cancer

作　　者：窦冬青 张天才[1] 郭广成[1] 张连平[1] 

机构地区：[1]郑州大学第一附属医院乳腺外科2病区,河南郑州450052

出　　处：《河南医学研究》2015年第12期3-6,共4页Henan Medical Research

摘　　要：目的观察新辅助化疗对浸润性乳腺癌患者外周血及组织中CD4+CD25+FOXP3+Treg细胞的影响,探讨FOXP3+Tregs对乳腺癌新辅助化疗疗效的预测价值。方法回顾性分析郑州大学第一附属医院2013年1月至2014年12月期间收治的73例治疗前均经病理活检证实的女性浸润性乳腺癌患者,采用TAC方案(多西他赛+阿霉素+环磷酰胺)新辅助化疗2个周期。采集新辅助化疗前1 d和化疗后第10天的外周静脉血,应用流式细胞仪检测外周血中CD4+、Treg细胞的变化;采用免疫组化法检测乳腺癌组织中FOXP3的表达,评估患者新辅助化疗后的疗效,并分析FOXP3+Tregs的高低与病理完全缓解率(p CR)之间的关系。结果乳腺癌患者新辅助化疗后外周血中Treg细胞明显下降,CD4+细胞及CD4+细胞/Treg细胞显著升高,差异具有统计学意义(P<0.05)。化疗后57例有效组患者Treg细胞较16例无效组患者明显降低,差异有统计学意义(P<0.05)。p CR为17.8%,而FOXP3+Tregs高表达患者较低表达患者病理完全缓解率低(P=0.016)。结论新辅助化疗可降低乳腺癌患者外周血Treg细胞的比例;乳腺癌组织中Treg细胞FOXP3表达水平可预测乳腺癌新辅助化疗的疗效,将作为指导乳腺癌治疗的一个潜在指标。Objective To observe the effect of the neoadjuvant chemotherapy on CD4^＋ CD25^＋ FOXP3^＋ Treg cells in the peripheral blood and tissues of the patients with invasive breast cancer, and explore the predictive value of the FOXP3^＋ Tregs to the efficacy of neoadjuvant chemotherapy of breast cancer. Methods A total of 73 female patients with invasive breast cancer confirmed by pathological biopsy before treatment in the First Affiliated Hospital of ZhengZhou University from January of 2013 to December of 2014 were retrospectively analyzed. During two cycles of the TAC regimen as neoadjuvant chemotherapy, peripheral venous blood samples were collected on the first day before neoadjuvant chemotherapy and the tenth day after neoadjuvant chemotherapy, and flow eytometry was used to test the changes of CD4^＋ and Treg cells in peripheral blood. FOXP3 Tregs in tissue were assessed by immunohistoehemistry, and the relationship between the high or low expression of FOXP3 ＋ Tregs and the pathological complete response （pCR） rate was analyzed. Results Treg cells in the peripheral blood of patients with breast cancer were decreased obviously. However, CD4^＋ cells and CD4 ^＋ cells/Treg cells were increased significantly after neoadjuvant chemotherapy, and the difference was statistically significant（P 〈0. 05）. Treg cells in the 57 patients from effective chemotherapy group were significantly lower than 16 patients of invalid group （ P 〈 0. 05 ）. The pCR was 17.8%. Compared with the patients with low expression of FOXP3^＋ Tregs, pathologic complete response rate was lower in patients with high expression of FOXP3 ^＋ Tregs （ P = 0. 016 ）. Conclusion Neoadjuvant chemotherapy can reduce the proportion of Treg cells in peripheral blood of breast cancer patients. The expression level of FOXP3 in Treg cells of breast cancer tissue can predict the curative effect of neoadjuvant chemotherapy, and will serve as a potential indicator of breast cancer treatment.

关 键 词：乳腺肿瘤 新辅助化疗 CD4^+CD25^+FOXP3^+调节性T细胞 

分 类 号：R737.9[医药卫生—肿瘤]