摘要目的 通过对三阴性乳腺癌患者穿刺组织样本中拓扑异构酶Ⅱα(TOP2A)、表皮生长因子受体(EGFR)基因检测,探讨二者表达与多西他赛联合表柔比星(TE)方案新辅助化疗疗效的相关性.方法 采用分支DNA-液相芯片技术,对53例接受TE方案新辅助化疗的三阴性乳腺癌患者化疗前穿刺样本进行基因检测,回顾性分析TOP2A、EGFR基因表达情况与化疗疗效达到完全病理缓解(pCR)之间关系.结果 53例三阴性乳腺癌组织中,TOP2A高表达率为35.8％(19/53),EGFR高表达率为39.6％ (21/53).三阴性乳腺癌患者接受TE方案新辅助化疗整体pCR率为18.9％ (10/53);其中TOP2A高表达的三阴性患者pCR率为31.6％ (6/19),高于低表达患者11.8％ (4/34),差异无统计学意义(P＞0.05);EGFR高表达的三阴性患者pCR率为28.6％ (6/21),高于低表达患者12.5％(4/32),差异无统计学意义(P＞0.05);TOP2A、EGFR基因表达联合统计结果,二者均高表达三阴性患者pCR率达75.0％ (6/8),明显高于所有三阴性患者整体pCR率,差异有统计学意义(P＜0.01).结论 TOP2A、EGFR基因表达对三阴性乳腺癌患者TE方案新辅助化疗疗效具有预测价值,有助于制定更为个体化的化疗方案.

abstractsObjective To retrospectively analyze the relevance between DNA topoisomerase Ⅱ alpha (TOP2A),epidermal growth factor receptor (EGFR) gene expression and efficacy of docetaxel plus epirubicin as neoadjuvant chemotherapy in triple negative breast cancer (TNBC) patients.Methods A total of 53 women with triple negative breast cancer who underwent docetaxel plus epirubicin as neoadjuvant chemotherapy were included in this study.The gene detection was done in the samples before chemotherapy by DNA chip technology.The relevance between TOP2A,EGFR gene expression and efficacy,pathological complete response (pCR) rate of neoadjuvant chemotherapy were retrospectively analyzed.Results The high expression rate of TOP2A in all the TNBC patients was 35.8％ (19/53),while the rate of EGFR was 39.6％ (21/53).The overall pCR rate of TNBC patients who underwent docetaxel plus epirubicin as neoadjuvant chemotherapy was 18.9％ (10/53).The pCR rate was 31.6％ (6/19) in TNBC patients whose TOP2A expression was high,compared to 11.8％ (4/34) in whose was low (P ＞ 0.05).The pCR rate was 28.6％ (6/21) in TNBC patients whose EGFR expression was high,compared to 12.5％ (4/32) in whose was low (P ＞ 0.05).The pCR rate was 75.0％ (6/8) in TNBC patients whose TOP2A,EGFR expression were both high,and was significantly higher than that in all the TNBC patients (P ＜ 0.01).Conclusions Efficacy of docetaxel plus epirubicin as neoadjuvant chenotherapy in TNBC patients can be predicted by detecting TOP2A,EGFR gene expression.The result may contribute to the development of more individualized neoadjuvant chemotherapy.