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学科主题: 临床医学
题名:
乳腺癌新辅助化疗疗效与PI3K/mTOR通路的相关性分析
其他题名: Relationship between the response of breast cancer to neoadjuvant chemotherapy and PI3K/mTOR pathway
作者: 欧柳菁; 张弛; 段学宁; 刘荫华
关键词: 乳腺肿瘤 ; 新辅助化疗 ; PI3K通路 ; 预测因子 ; Breast neoplasms ; Neoadjuvant chemotherapy ; PI3K pathway ; Predictive factor
刊名: 中华医学杂志
发表日期: 2012
DOI: 10.3760/cma.j.issn.0376-2491.2012.34.003
卷: 92, 期:34, 页:2382-2385
收录类别: 中国科技核心期刊 ; 中文核心期刊 ; CSCD
文章类型: Journal Article
摘要: 目的 观察PI3 K/mTOR通路状态与乳腺癌新辅助化疗疗效之间的关系.方法 对2009年1月至2010年11月在北京大学第一医院乳腺疾病中心接受4~6个周期包含紫杉方案新辅助化疗的105例乳腺癌患者资料进行回顾性分析.用免疫组织化学方法检测新辅助化疗前肿瘤病灶PTEN、p-AKT( Ser473)和p-mTOR( Ser2448)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精确概率法和双边Logistic 回归探讨上述指标与新辅助化疗疗效之间的相关性.结果 105例患者中新辅助化疗有效率为58.1% (61/105),其中PCR占27.6% (29/105).PTEN、p-AKT和p-mTOR的阳性表达率分别为52.4% (55/105)、68.6% (72/105)、43.8% (46/105).x2检验、Fisher精确概率法分析表明p-mTOR 与新辅助化疗疗效相关(P =0.003),与获得PCR相关(P=0.001);双边Logistic回归表明p-mTOR是新辅助化疗疗效和获得PCR(均P<0.01)的独立预测指标.p-AKT与p-mTOR表达水平差异有统计学意义(P=0.000).p-AKT与PR表达差异同样有统计学意义(P =0.035).结论 p-mTOR状态对于包含紫杉方案的新辅助化疗有预测意义,高表达患者疗效差,低表达患者更多地从化疗中获益. Objective To explore the relationship between the status of PI3K/mTOR pathway and the therapeutic efficacies of neoadjuvant chemotherapy for breast cancer.Methods A total of 105 patients receiving 4 -6 cycles of taxane-based neoadjuvant chemotherapy at our centre between January 2009 and November 2010 were recruited into this retrospective study.The expressions of PTEN,p-AKT (Ser473) and p-mTOR (Ser2448) were detected by immunohistochemistry before neoadjuvant chemotherapy. We employed pathology to evaluate the therapeutic efficacies and considered complete response (G4) & pathologic complete response (PCR) as efficacious.Fourfold table Chi-square test and binary Logistic regression were used to analyze the relationship between the above features and therapeutic efficacies.Results The overall efficacy rate of neoadjuvant chemotherapy was 58.1% (61/105) and the PCR rate 27.6% (29/105).The positive expression rates of PTEN,p-AKT and p-mTOR were 52.4% (57/105),68.6% (72/105) and 43.8% (46/105) respectively.Fourfold table Chi-square test showed the difference between p-mTOR and therapeutic efficacy was significant statistically ( P =0.003 ) and also the difference between pmTOR and PCR ( P =0.001 ). Binary Logistic regression showed the difference between p-mTOR and therapeutic efficiency was significant statistically,and also the difference between p-mTOR and PCR (both P < 0.01 ).The differential expressions of p-mTOR and p-AKT were statistically significant (P =0.000) and so were those of p-AKT and PR (P =0.035).Conclusions The status of p-mTOR has predictive values for taxane-based neoadjuvant chemotherapy. The patients with a low level of p-mTOR are more responsive to thermotherapy while those with a high level of p-mTOR have a worse efficacy.
语种: 中文
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内容类型: 期刊论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/48808
Appears in Collections:北京大学第一临床医学院_期刊论文

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作者单位: 100034,北京大学第一医院乳腺疾病中心

Recommended Citation:
欧柳菁,张弛,段学宁,等. 乳腺癌新辅助化疗疗效与PI3K/mTOR通路的相关性分析[J]. 中华医学杂志,2012,92(34):2382-2385.
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