TUBB3和TopoⅡα表达与老年女性乳腺癌患者术后化疗临床预后的回顾性分析

摘要

目的 回顾分析TUBB3和TopoⅡα表达与乳腺癌患者术后化疗临床预后的关系.方法 收集2012年1月-2014年6月复旦大学附属华山医院及静安分院收治的术后接受辅助化疗老年女性乳腺癌患者3年临床随访资料,并收集病理蜡块切片标本TUBB3和TopoⅡα表达情况,比较不同情况下TUBB3组和TopoⅡα表达组临床结局.结果 研究共收集到老年女性乳腺癌病例共计209例,平均年龄为(68.3±6.4)岁;乳腺癌临床分期均为ⅡA期以上(ⅡA期67例、ⅡB期74例、ⅢA期68例),接受紫杉类方案化疗者65例,接受蒽环类方案化疗者73例,蒽环类联合紫杉类方案化疗者71例.第3年随访终末时共有58例患者发生复发、转移和死亡,复发率为27.75％(43例),死亡率为7.18％(15例).TUBB3阳性率48.80％ (102/209),TopoⅡα阳性率48.32％ (101/209).3年随访终止时,TUBB3阳性组患者的复发率(27.45％,28/102)高于TopoⅡα组(14.85％,15/101) (x2=4.82,P＜0.05);TUBB3阳性组与TopoⅡα组之间的死亡率差异无统计学意义(9.80％vs4.95％)(x2=1.95,P＞0.05);TUBB3表达组和TopoⅡα表达组在3组化疗方案之间缓解、复发和死亡例数构成比差异均有统计学意义(Fisherx,x2TUBB3 =9.55,P=0.042;Fisherx2TopoⅡα=8.68,P=0.045);TUBB3表达组缓解例数构成比(62.74％,64/102)低于TopoⅡα组(80.20％,81/101) (x2=7.58,P＜0.05).结论 TUBB3和TopoⅡα表达与老年女性乳腺癌患者术后化疗3年临床结局相关,临床研究应关注TUBB3和TopoⅡα表达对乳腺癌患者术后化疗预后的影响.%Objective To make a retrospective analysis on the correlation of TUBB3 and Topo Ⅱα expressions to the clinical prognosis of the elderly women with breast cancer receiving postoperative chemotherapy.Methods The clinical follow-up data of the elderly women with breast cancer treated with postoerative chemotherapy in Huashan Hospital and Jing'an Branch during the period from Jan.,2012 to June,2014 were collected and the exressions of TUBB3 and Topo Iiα in the collected pathological wax slices were analyzed;a comparative study was made to the clinical outcomes in TUBB3 group and Topo Ⅱα group.Results In total,209 elderly women with breast cancer were enrolled,with the average age of 68.3±6.4,including 67 cases of clinical stage ⅡA,74 cases of clinical stage ⅡB and 68 cases of clinical stage ⅢA;65 cases received chemotherapy based on taxanes agent,73 cases received chemotherapy based on anthracycline and 71 cases received the combined chemotheray based on the 2;at the end of the 3-year follow-up,reoccurrence,metastasis and death were found in 58 cases with the reocurrence rate of 27.75％ (43 cases) and death rate of 7.18％ (15 cases);the postive rate of TUBB3 was 48.80％ (102/209) while that of Topo Ⅱα was 48.32％ (101/209);the reocurrence rate in TUBB3 was higher (27.45％,28/102) than that in Topo Ⅱα group (14.85％,15/101) (x2=4.82,P＜0.05);the difference in death rate between TUBB3 group and Topo Hα group was of no statistical significance (9.80％ vs 4.95％) (x2=1.95,P＞0.05);the constituent ratio of remission,relapse and death in 3 chemotherapies between TUBB3 group and Topo Ⅱt group were of statistical difference (Fisherx2TUBB3 =9.55,P=0.042;Fisherx2Topo Ⅱ α=8.68,P=0.045),the ratio in TUBB3 group (62.74％,64/102) was lower than that in Topo Ⅱα group (80.20％,81/101) (x2=7.58,P＜0.05).Conclusions The expressions of TUBB3 and Topo Ⅱα are in certain correlation to the clinical outcome 3 years after postoperative chemotherapy in the elderly women with breast cancer;more attention should be paid to the effect of TUBB3 and Topo Ⅱ α expressions on the prognosis of the patients with breast cancer receiving postoperative chemotherapy.