乳腺癌新辅助化疗Bcl-2和生存素的表达及其与化疗反应的相关性

目的 探讨乳腺癌新辅助化疗Bcl-2和生存素两种凋亡抑制蛋白的表达与新辅助化疗反应之间的相关性.方法 用免疫组化法(SP法)测定64例行新辅助化疗乳腺癌及38例术前未行化疗乳腺癌中Bcl-2和生存素的表达,观察癌组织的临床化疗反应与病理组织学上疗效,并分析它们之间的相关性.结果 (1)新辅助化疗组与未化疗组Bcl-2和生存素蛋白阳性率分别为65.6%、68.7%与60.5%、76.3%,两者比较差异均无显著性(P＞0.05).(2)64例乳癌新辅助化疗组中,化疗后临床有效者为39例(有效率为60.9%),病理组织学上有效者为35例(有效率为54.7%),Bcl-2与新辅助化疗反应之间的相关性不明显(P＞0.05),生存素与新辅助化疗反应之间存在负相关(P＜0.05).(3)乳癌组织中Bcl-2与生存素蛋白表达之间存在显著正相关性(P＜0.05).结论 生存素的高表达预示乳癌细胞对化疗的相对不敏感;Bcl-2和生存素两种凋亡抑制蛋白的共同表达可能在乳癌中起协同作用.

The expression of Bcl-2 and survivin protein and its relationship with therapeutic response of neoadjuvant chemotherapy in patients with breast cancer

Objective To explore the relationship between the expression of Bcl-2 and survivin and therapeutic response of neoadjuvant chemotherapy.Methods The expression of Bcl-2 and survivin were detected by immunohistochemistry in the tissues from 38 breast cancer patients without chemotherapy and 64 cases of breast cancer treated by neoadjuvant chemotherapy.Chemotherapy response was evaluated clinically and pathologically and their correlation was analyzed.Results Positive rates of Bcl-2 and survivin were 65.6%(42/64) and 68.7%(44/64)in the neoadjuvant chemotherapy group,and 60.5%(23/38) and 76.3%(29/38)in the control group,respectively.There were 39 cases effectual to chemotherapy clinically(effective rate 60.9%) and 35 cases effectual to chemotherapy pathologically(effective rate 54.7%) after chemotherapy in 64 cases with of breast cancer treated by neoadjuvant chemotherapy.There was no significant relevance between the expression of Bcl-2 and the response to chemotherapy(P>0.05).The expression of survivin was positively correted with the response to chemotherapy(P<0.05).There was a significant positive relevance between the expression of Bcl-2 protein and that of survivin protein in breast cancer(P<0.05).Conclusions The expression of survivin poorly indicates chemotherapeutic response in breast cancer. The co-expression of Bcl-2 and survivin might play a synergetic role in breast cancer.