p-AKT和HIF-1α蛋白表达水平与新辅助化疗治疗乳腺癌疗效的相关性分析

摘要

目的 研究分析磷酸化蛋白激酶(p-AKT)和低氧诱导因子-1α(HIF-1α)蛋白表达与乳腺癌新辅助化疗疗效之间的关系.方法 对温州市人民医院2014年1月～2016年12月收治的接受4~6个周期方案为TEC新辅助化疗的70例乳腺癌患者的资料进行回顾性研究.用免疫组织化学方法检测新辅助化疗前肿瘤病灶p-AKT和HIF-1α蛋白的表达情况,用术后病理评价新辅助化疗疗效,病理学反应级别为G4、病理完全缓解(PCR)则认为化疗有效.通过x2检验、Fisher确切概率法探讨上述指标与新辅助化疗疗效之间的相关性.结果 70例患者中新辅助化疗有效率为52.9%(37/70),其中PCR占21.4%(15/70).p-AKT和HIF-1α的阳性表达率分别为64.3%(45/70)和61.4%(43/70).x2检验、Fisher确切概率法分析表明p-AKT和HIF-1α均与新辅助化疗疗效相关(P=0.002,P=0.035),与获得PCR也相关(P=0.001, P=0.015).结论 化疗前,p-AKT和HIF-1α蛋白阳性表达状态降低患者对于相关乳腺癌治疗药物的敏感性,阴性表达患者能更多地从化疗中获益.%Objective To study the relationship between the expression of p-AKT and HIF-1αprotein and the response of breast cancer to neoadjuvant chemotherapy.Methods A retrospective study was performed on 70 cases of breast cancer patients receiving 4-6 cycles of TEC neoadjuvant chemotherapy in Wenzhou people's hospital from January 2014 to December 2016.Immunohistochemistry was applied to the detection of p-AKT and HIF-1αexpression before chemotherapy.Neoadjuvant chemotherapy response was evaluated according to the postoperative pathology.Pathological response to G4 or complete response were considered to be response efficaciously.Chi-square test and Fisher's test were applied to analyze the correlation between these index and the efficacy of neoadjuvant chemotherapy.Results The response rate of neoadjuvant chemotherapy was 52.9%(37/70)among the 70 cases, among which the pathological complete response(PCR)was 21.4%(15/70).The positive expression of p-AKT and HIF-1α were 64.3%(45/70)and 61.4%(43/70)respectively.Statistical analysis shows that p-AKT and HIF-1α expression were associated with the response of neoadjuvant chemotherapy of breast cancer(P=0.002, P=0.035), and also associated with the PCR(P=0.001, P=0.015).Conclusion p-AKT and HIF-1αexpression in breast cancer reduce the sensitivity of neoadjuvant chemotherapy to breast cancer.Patient with negative expression may benefit more from neoadjuvant chemotherapy.