SPAG5在原发性乳腺癌中的表达与TEC方案新辅助化疗敏感性的关系

摘要

目的 观察精子相关抗原5(SPAG5)在乳腺癌组织中的表达,探讨其表达情况与临床病理因素及TEC方案(T:多西他赛,E:表柔比星,C:环磷酰胺)新辅助化疗疗效之间的关系.方法 收集107例接受TEC方案新辅助化疗的乳腺癌患者化疗前的组织标本,通过免疫组织化学法检测各标本中SPAG5蛋白的表达,结合临床病理因素及新辅助化疗疗效进行分析.结果 107例原发性乳腺癌组织中SPAG5蛋白高表达率48.6％ (52/107),与人类表皮生长因子受体2过表达呈正相关性(P=0.000),与细胞增殖核抗原过表达呈正相关性(P =0.019).SPAG5的表达在患者年龄、肿瘤大小、肿瘤分期、组织学分级、淋巴结状况、雌激素受体及孕激素受体的表达情况中均差异无统计学意义.化疗总体客观缓解(OR)率为70.1％(75/107),其中病理完全缓解(pCR)率9.3％(10/107),SPAG5高表达组OR率为82.7％(43/52),低表达组56.1％(32/57),差异有统计学意义(P=0.006).SPAG5高表达组pCR率为15.4％ (8/44),SPAG5低表达组pCR率为3.6％(2/53),差异有统计学意义(P=0.048).结论 SPAG5作为肿瘤增殖指标,其表达状态对于乳腺癌患者TEC方案新辅助化疗的疗效具有预测作用.%Objective To explore the expression of sperm associated antigen5 (SPAG5) and discuss the relationship between expression,clinicopathologic characteristics and sensitivity to neoadjuvant chemotherapy in primary breast cancer.Methods The tissue of 107 patients treated with TEC(T:Docetaxel E:Epirubicin C:Cytoxan) neoadjuvant chemotherapy with primary breast cancer were collected to measure the expression of SPAG5 by immunohistochemical staining.Data were analysed to investigate the correlation to clinicpathologic factors and chemotherapyresponse.Results The over-expressed rate of SPAG5 from tissues of primary breast cancer was 48.6％ (52/ 107) and proved to be positively correlated to the over-expression of human epidermal growth factor receptor-2 (P =0.000) and proliferating cell nuclear antigen (P =0.019).However there were no significant correlations between age,tumor size,TNM stage,histological grading,lymphnode status and the expression level of estrogen receptor and progesterone receptor.The overall objective response(OR) rate was 70.1％ (75/107) and the pathologic complete response(pCR) rate was 9.3％ (10/107)after neoadjuvant chemotherapy.The objective response rates were 82.7％ (43/52) in SPAG5 over-expression group and 56.1％ (32/57)in low-expression group,and the difference was statistically significant(P =0.006).The rates of pCR were 15.4％ (8/44) in group of SPAG5 over-expression and 3.6％ (2/53)in low-expression group,which proved significantly different by Fisher exact probability test(P =0.048).The OR rate and pCR rate of patients with over-expression of SPAG5 were higher than low-expression ones.Conclusion SPAG5 as a tumor proliferation index,its expression status for breast cancer patients with TEC regimen neoadjuvant chemotherapy has a predictive effect.