CAJ | 학술논문

目的探讨C-erbB-2、磷酸化蛋白激酶B(p-Akt)蛋白表达与乳腺癌新辅助化疗(NAC)疗效的关系.方法 2008年10月至2011年2月在我院收治的实施NAC后手术治疗的30例TNM分期为Ⅱ/Ⅲ期女性乳腺癌患者,采用免疫组织化学法检测化疗前石蜡包埋组织C-erbB-2、p-Akt蛋白的表达,原位末端转移酶标记(TUNEL)法检测手术后石蜡包埋组织肿瘤细胞凋亡指数(AI),结合NAC疗效进行分析.结果 NAC治疗后客观缓解率为80.0％ (24/30)；治疗有效患者平均AI为26.7％,无效患者平均AI为13.2％,AI与化疗效果呈正相关(r=0.782,P＜0.01)；C-erbB-2和p-Akt的阳性率分别为80.0％和83.3％,其中p-Akt高表达率为53.3％,p-Akt的表达与C-erbB-2呈正相关(r =0.546,P＜0.01)；C-erbB-2阴性及阳性表达患者AI值分别为30.8％及17.2％,p-Akt低表达及高表达患者AI值分别为29.9％及18.9％,AI与C-erbB-2及p-Akt表达之间均呈负相关(P＜0.05).结论 C-erbB-2和p-Akt高表达可能抵抗化疗药物诱导肿瘤细胞凋亡的作用而影响乳腺癌NAC的疗效.
목적 탐토C-erbB-2、린산화단백격매B(p-Akt)단백표체여유선암신보조화료(NAC)료효적관계.방법 2008년10월지2011년2월재아원수치적실시NAC후수술치료적30례TNM분기위Ⅱ/Ⅲ기녀성유선암환자,채용면역조직화학법검측화료전석사포매조직C-erbB-2、p-Akt단백적표체,원위말단전이매표기(TUNEL)법검측수술후석사포매조직종류세포조망지수(AI),결합NAC료효진행분석.결과 NAC치료후객관완해솔위80.0％ (24/30)；치료유효환자평균AI위26.7％,무효환자평균AI위13.2％,AI여화료효과정정상관(r=0.782,P＜0.01)；C-erbB-2화p-Akt적양성솔분별위80.0％화83.3％,기중p-Akt고표체솔위53.3％,p-Akt적표체여C-erbB-2정정상관(r =0.546,P＜0.01)；C-erbB-2음성급양성표체환자AI치분별위30.8％급17.2％,p-Akt저표체급고표체환자AI치분별위29.9％급18.9％,AI여C-erbB-2급p-Akt표체지간균정부상관(P＜0.05).결론 C-erbB-2화p-Akt고표체가능저항화료약물유도종류세포조망적작용이영향유선암NAC적료효.
Objective To investigate the relationship between the expression of C-erbB-2 and pprotein kinase B (p-Akt) proteins with the efficacy of neoadjuvant chemotherapy (NAC) in breast cancer.Methods From October 2008 to February 2011,30 female patients with stage Ⅱ-Ⅲ primary breast cancer received 2-4 cycles of NAC with CEF/TE before surgery in our hospital.The expression of C-erbB-2 and p-Akt in paraffin-embedded tissue before chemotherapy was detected by using immunohistochemistry,and apoptosis index (AI) of breast cancer cells in paraffin-embedded tissues after surgery was assayed by TdTmediated dUTP nick end labeling (TUNEL).The relationships between these indicators and NAC efficacy were analyzed.Results The objective response rate of NAC treatment was 80.0％.The mean AI of effective treatment was 26.7％,and that of ineffective treatment was 13.2％.AI was positively correlated with the effect of chemotherapy (r =0.782,P ＜ 0.05).The positive expression rate of C-erbB-2 and p-Akt proteins was 80.0％ and 83.33％,respectively,and p-Akt was overexpressed in 53.3％ of patients.There was a positive correlation between p-Akt and C-erbB-2 (r =0.546,P ＜0.01).The mean AI of the patients negative or positive for C-erbB-2 expression was 30.8％ and 17.2％,respectively.The mean AI of the patients with p-Akt low or high expression was 29.9％ and 18.9％,respectively.There was negative correlation between AI and C-erbB-2 as well as between AI and p-Akt (low expression and high expression) (P ＜0.05).Conclusion C-erbB-2 and p-Akt overexpression may affect NAC efficacy by resisting to chemotherapeutic drug-induced apoptosis of breast cancer cells.