蒽环类药物新辅助化疗对乳腺癌患者耐药基因ERCC1表达的影响及临床意义  

Effect of anthracycline-based neoadjuvant chemotherapy on the expression of drug resistance gene ERCC1 in breast cancer and its clinical significance

作　　者：李纲 杨梅 左丽 李小静[2] 王妹兴 党雪菲 李小丽 LI Gang;YANG Mei;ZUO Li;LI Xiao-jing;WANG Mei-xing;DANG Xue-fei;LI Xiao-li(Department of Medical Oncology, Minhang Branch of Cancer Hospital Affiliated to Fudan University, Shanghai 200240, China;Department of Pathology, Fifth People＇s Hospital Affiliated to Fudan University, Shanghai 200240, China)

机构地区：[1]上海市复旦大学附属肿瘤医院闵行分院肿瘤内科,上海200240 [2]上海市复旦大学附属第五人民医院病理科,上海200240

出　　处：《中国肿瘤临床与康复》2018年第5期537-541,共5页Chinese Journal of Clinical Oncology and Rehabilitation

基　　金：上海市闵行区卫生和计划生育委员会课题(2014MW19)

摘　　要：目的探讨蒽环类药物新辅助化疗(NC)对乳腺癌患者耐药基因切除修复交叉互补基因1(ERCC1)表达的影响及临床意义。方法选取2015年1月至2016年12月间复旦大学附属肿瘤医院闵行分院收治的接受手术治疗的98例乳腺癌患者,按照术前是否实施蒽环类药物NC治疗分为观察组(50例)和对照组(48例)。观察组患者术前予以蒽环类药物NC治疗,对照组不进行NC治疗,术后对比对照组患者的病理特征与ERCC1mRNA表达水平的关系及两组患者ERCC1mRNA表达水平及阳性率,并分析观察组患者疗效及不良反应。结果对照组患者的病理特征不同,ERCC1mRNA表达水平无差异,差异无统计学意义(P>0.05)。治疗后,观察组患者总缓解率为64.0%,不良反应总发生率为68.0%。观察组患者ERCC1mRNA表达水平及阳性率明显高于对照组患者,差异均有统计学意义(均P<0.05)。结论 ERCC1表达与乳腺癌患者病理特征无明显关联,采用蒽环类药物实施NC对于乳腺癌耐药基因ERCC1的表达具有明显的提升作用,临床可考虑监测ERCC1基因表达助于评估患者病情。Objective To study the effect of anthracycline-based neoadjuvant chemotherapy（NC）on the expression of drug resistance gene excision repair cross complementing gene 1（ERCC1） in breast cancer and its clinical significance. Methods A total of 98 patients with breast cancer who underwent surgical treatment at Minhang Branch of Cancer Hospital Affiliated to Fudan University from January 2015 to December 2016 were selected for the study. The patients were divided into an observation group（50 patients） and a control group（48 patients） according to the preoperative implementation of anthracycline NC treatment. The observation group was treated with anthracycline-based NC before operation and the control group was not treated with NC. The expression level of ERCC1 mRNA in patients with different pathological characteristics in the control group and the expression level and positive rate of ERCC1 mRNA in the two groups after operation was compared. The efficacy and adverse reactions in the observation group were analyzed. Results There was no significant difference in the expression level of ERCC1 mRNA among patients with different pathological features in the control group（P〉0. 05）. The overall remission rate was 64. 0% in the observation group,and the overall incidence of adverse reactions was 68. 0% in the observation group after the treatment. The expression level and positive rate of ERCC1 mRNA in the observation group were significantly higher than those in the control group,and the differences were statistically significant（P〈0. 05）.Conclusion The expression of ERCC1 was not correlated with the pathological features of the patients,and the use of anthracycline-based NC can significantly improve the expression of drug resistance gene ERCC1 in breast cancer. Monitoring the expression of ERCC1 gene may help to assess the patient＇s condition.

关 键 词：蒽环类药物 新辅助化疗 乳腺肿瘤 耐药基因 ERCC1 

分 类 号：R737.4[医药卫生—肿瘤]