TUBB3和TOP2A与晚期乳腺癌患者临床病理特征及与紫杉类联合蒽环类药物治疗疗效的关系

目的 探讨3型β微管蛋白(3 beta tubulin,TUBB3)和拓扑异构酶2(topoisomerase 2,TOP2A)在晚期乳腺癌患者乳腺组织中的表达及其与患者临床病理特征的关系,并分析TUBB3和TOP2A表达与患者接受紫杉类联合蒽环类药物治疗效果的关系.方法 回顾性分析我院2015年收治的60例确诊的晚期乳腺癌患者,采用液相芯片法检测患者乳腺组织中TUBB3和TOP2A mRNA的表达,比较不同病理特征患者的TUBB3和TOP2A mRNA表达差异;两组患者均采用(多西他赛+吡柔比星+异环磷酰胺)/(紫杉醇+表柔比星+环磷酰胺)(PAC/PEC)进行化疗,4周后进行疗效评价,并分析临床效果与TUBB3和TOP2A mRNA表达的相关性.结果 TUBB3 mRNA表达在不同乳腺癌组织学分级患者间的差异具有统计学意义(P＜0.05);TOP2A mRNA表达与患者的年龄、是否绝经、组织学分级、是否淋巴结转移、ER表达、PR表达、HER-2表达关系不显著(P＞0.05);TUBB3 mRNA低表达患者的缓解率高于高表达患者(57.14％ vs 14.71％,x2=5.299,P＜0.05);TUBB3 mRNA低表达、中表达患者的总有效率均高于高表达组(92.86％、83.33％ vs 52.94％,x2=10.533、4.190,P＜0.05);TOP2AmRNA高表达患者的总有效率高于低表达组(93.55％ vs 69.23％,x2=3.967,P＜0.05).结论 TUBB3 mRNA表达与乳腺癌组织学分级有关,TUBB3低表达、TOP2A高表达患者应用PAC/PEC的效果更好.

Relationships of TUBB3 and TOP2A expression with clinical and pathological features and paclitaxel and anthracycline drug therapeutic effect in patients with advanced breast cancer

Objective To study the expression of β-tubulin-Ⅲ (TUBB3) and topoisomerase Ⅱ alpha (TOP2A) in patients with advanced breast cancer breast and its relationship with clinical and pathological features of the patients,and analyze the relationship of TUBB3 and TOP2A expression with paclitaxel and anthracycline drug therapeutic effect.Methods Sixty patients with advanced breast cancer were selected to detect TUBB3 and TOP2A mRNA expression with liquid-phase chip method,and the TUBB3 and TOP2A mRNA expression levels in the patients with different pathological features was compared.The patients were administered with (docetaxel + pirarubicin + ifosfamide)/(paclitaxel + epirubicin + cyclophosphamide) (PAC/PEC) for 4 weeks.The therapeutic effect was evaluated,and its correlation with TUBB3 and TOP2A mRNA expressions was analyzed.Results TUBB3 mRNA levels in the breast cancer patients with different histological grades had statistically significant difference (P ＜ 0.05).The correlation of TOP2A mRNA expression with age,menopause,histological grade,lymph node metastasis,ER expression,PR expression,and HER-2 expression was not significant (P ＞0.05).The remission rate (57.14％) in the patients with low expression of TUBB3 mRNA was significantly higher than that (14.71％) in the patients with high expression (chi square =5.299,P ＜0.05).The total efficiencies (92.86％ and 83.33％) of the patients with low and median expressions of TUBB3 mRNA were significantly higher than that (52.94％) of the patients with high expression (chi square =10.533,4.190,P ＜0.05).The total efficiency (93.55％) of the patients with high expression of TOP2A mRNA was significantly higher than that (69.23％) of the patients with low expression (chi square--3.967,P ＜ 0.05).Conclusion TUBB3 mRNA expression is correlated with the histological grading of breast cancer,and PAC/PEC shows good therapeutic effect in the patients with low TUBB3 expression and high TOP2A expression.