乳腺癌患者细胞周期蛋白依赖性激酶5调节亚基相关蛋白2表达与新辅助化疗疗效的相关性研究

摘要

Objective To detect the CDK5RAP2 expression in breast cancer before neoadjuvant chemotherapy (NAC),and analyze its value in evaluating the effect of NAC. Methods 191 patients with primary invasive breast in Department of Breast Surgery,Tianjin Medical University Cancer Institute and Hospital in 2014 were selected. The clinical and pathological data were collected,including age,family history of cancer,menopausal status,tumor diameter,lymph node metastasis,clinical stage,and molecular type. Breast cancer tissue specimens were needle aspirated and the expression of CDK5RAP2 was determined by immunohistochemistry. After 6 cycles of TEC NAC,patients accepted radical mastectomy or breast - conserving surgery. The chemotherapy effect was preoperatively evaluated. Results In patients,18 cases(9. 4% ) got pCR,23 cases(12. 1% )got cCR,106 cases(55. 5% )got PR and 44 cases(23. 0% )got SD. There were statistically significant difference in the efficacy of NAC among patients with different tumor diameter and molecular type( P < 0. 05). CDK5RAP2 expression was negative in 38 patients(19. 9% )and positive in 153 patients(80. 1% ). There was statistically significant difference in the efficacy of NAC among patients between different CDK5RAP2 expression(P < 0. 05). There were no statistically significant difference in the efficacy of NAC between different CDK5RAP2 expression among Luminal A,basal - like breast cancer patients( P > 0. 05). There were statistically significant difference in the efficacy of NAC between different CDK5RAP2 expression among Luminal B,Her-2 positive breast cancer patients(P < 0. 05). Conclusion The expression of CDK5RAP2 could predict the efficacy of NAC in breast cancer,especially in Luminal B and Her-2 positive breast cancer.%目的：通过检测新辅助化疗前乳腺癌组织中细胞周期蛋白依赖性激酶5调节亚基相关蛋白2（CDK5RAP2）表达情况，分析其对乳腺癌新辅助化疗效果的评估作用。方法选取2014年于天津医科大学肿瘤医院乳腺外科初诊的女性乳腺癌患者191例为研究对象。收集患者临床病理资料，包括年龄、肿瘤家族史、绝经状态、肿瘤直径、淋巴结转移、临床分期、分子分型等；针吸乳腺癌组织标本，采用免疫组织化学法检测 CDK5RAP2表达。患者接受6个周期的 TEC 新辅助化疗后进行乳腺癌仿根治术或保乳手术，术前评估化疗疗效。结果本组患者中，18例（9.4%）患者获得病理完全缓解（pCR），23例（12.1%）患者获得临床完全缓解（cCR），106例（55.5%）患者获得部分缓解（PR），44例患者（23.0%）获得稳定（SD）。不同肿瘤直径、分子分型的患者新辅助化疗疗效比较，差异有统计学意义（P <0.05）。38例（19.9%）患者 CDK5RAP2表达阴性，153例（80.1%）患者 CDK5RAP2表达阳性。不同 CDK5RAP2表达的乳腺癌患者新辅助化疗疗效比较，差异有统计学意义（P <0.05）。不同 CDK5RAP2表达的 Luminal A 型、基底样乳腺癌患者新辅助化疗疗效比较，差异无统计学意义（ P >0.05）。不同 CDK5RAP2表达的Luminal B 型、Her-2阳性乳腺癌患者新辅助化疗疗效比较，差异均有统计学意义（P <0.05）。结论 CDK5RAP2表达对 Luminal B 型及 Her-2阳性乳腺癌患者新辅助化疗疗效具有一定的预测作用。