背景与目的:Tau蛋白是一种微管相关蛋白,在正常乳腺上皮细胞和乳腺癌中有表达,对乳腺癌的预后判断具有重要的意义.本研究旨在探讨乳腺癌组织Tau蛋白的表达情况,其与临床特征的关系和对紫杉类化疗敏感性的预测价值.方法:采用免疫组化Elivison二步法检测200例乳腺癌患者术前穿刺组织的Tau蛋白表达,X2检验分析其与乳腺癌临床特征的关系,logistic多因素回归分析紫杉类药物新辅助化疗治疗乳腺癌病理完全缓解率(pathologic complete response,pCR)的预测指标.结果:进展期乳腺癌患者Tau蛋白的阳性表达率为44％,与患者的年龄、临床分期及术后淋巴结转移无相关性(P＞0.05),与乳腺癌组织的雌激素受体(estrogen receptor,ER)、孕激素受体(progesterone receptor,PR)、表皮生长因子受体-2 (Her-2/Neu)及增殖指数Ki-67阳性表达均相关(P＜0.01).pCR预测指标的多因素分析发现,术后淋巴结转移和Tau蛋白的表达是pCR的独立预测指标(P=0.009、0.001).结论:临床检测Tau蛋白表达可作为乳腺癌紫杉类化疗方案选择依据.%Background and purpose: Tau is a microtubule-associated protein and expressed in normal breast epithelial cells and breast cancer. Tau expression in breast cancer may be important for treatment optimization and prognostic analysis. This study mainly investigated the expression of Tau protein in breast cancer, its relationship with the clinical features and its predictive value for chemo-sensitivity of taxane. Methods: The expression of Tau protein in biopsy tissues was detected by Elivison two-step immunohistochemical methods, which were collected from 200 patients with primary breast cancer before neoadjuvant chemotherapy. The result of Tau expression was analyzed for the correlation to clinical features byx2 test. The predictors of pathologic complete response rate (pCR) in taxane-containing neoadjuvant chemotherapy were determined by logistic multiple regression analysis. Results: Tau expression in advanced breast cancer was 44%, which were not correlated with patient's age, clinical stage and postoperative lymph node metastasis (P>0.05), but associated with estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor -2 (Her-2/Neu) and Ki-67 (P<0.01). Multivariate analysis showed that postoperative lymph node metastasis and the expression of Tau protein entered the logistic regression equation (P=0.009, 0.001). Conclusion: The detection of Tau expression in breast cancer may be a clinical basis to choose taxane-containing chemotherapy.
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