Relationship of CD44＋/CD24－/low with Responsiveness of Breast Cancer to Anthracycline-based Chemotherapy
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摘要: 目的 研究乳腺癌中CD44＋/CD24－/low的表达及其与含蒽环类药物化疗方案敏感度的关系。方法91例乳腺癌接受含蒽环类药物的术前新辅助化疗,2~4个疗程后进行效果评价;采用双染免疫组织化学方法检测化疗前后CD44＋/CD24－/low的表达,t检验分析化疗前后CD44＋/CD24－/low细胞比例的变化,χ2检验分析乳腺癌CD44＋/CD24－/low表型与乳腺癌临床病理参数及化疗疗效的关系。结果乳腺癌中CD44＋/CD24－/low阳性表达率为39.6%(36/91),在接受含蒽环类药物的新辅助化疗后乳腺癌中CD44＋/CD24－/low细胞比例较化疗前明显增加(P=0.028)。CD44+/CD24-/low阳性组ER阳性率明显低于CD44+/CD24-/low阴性组(25.0% vs.47.3%,P=0.033)。三阴性乳腺癌中CD44+/CD24-/low阳性率明显高于非三阴性乳腺癌(61.9% vs.32.9%,P=0.017)。CD44+/CD24-/low表型与年龄、肿瘤大小、临床分期、病理类型、组织学分级等乳腺癌临床病理参数无明显关系(P>0.05)。CD44+/CD24-/low阳性组的总有效率高于CD44+/CD24-/low阴性组,但两组之间差异无统计学意义(75% vs.69.1%,P=0.542);CD44+/CD24-/low阳性组的病理完全缓解率明显高于CD44+/CD24 -/low阴性组(38.9% vs.18.2%,P=0.028)。结论CD44+/CD24-/low细胞仅存在于部分乳腺癌,CD44+/CD24-/low表型与ER(﹣)、三阴性乳腺癌相关,CD44+/CD24-/low表型与乳腺癌对含蒽环类药物化疗方案的敏感度相关,CD44+/CD24-/low表型可能成为乳腺癌临床化疗疗效的预测指标之一。Abstract: Objective To evaluate the expression of CD44＋/CD24－/low and the relationship between CD44＋/CD24－/low and the response to anthracyclines-based chemotherapy in patients with breast cancer. Methods A total of 91 patients with breast cancer were treated with anthracycline-based neoadjuvant chemotherapy,and the clinical response to the chemotherapy was obtained after 2 to 4 cycles.Double-staining immunohistochemistry was used to detect the expression of CD44＋/CD24－/low in paraffin-embedded tissues of pre-chemotherapy and post-chemotherapy.Data was analyzed via t test and Chi-square test. Results The expression rate of CD44＋/CD24－/low phenotype was 39.6%(36/91).The proportions of CD44+/CD24-/lowcells were significantly increased after anthracyclines-based chemotherapy (P=0.028).The positive rate of ER in CD44+/CD24-/low positive group was lower than that in CD44+/CD24 -/low negative group(25.0% vs.47.3%,P=0.033).And the expression rate of CD44＋/CD24－/low phenotype in triple negative breast cancer was higher than that in non-triple negative breast cancer(61.9% vs. 32.9%,P=0.017).There was no significant correlation between CD44+/CD24-/low phenotype and the other clinicopathological parameters,such as age,tumor size,TNM classification,pathological type,histological grade and so on(P>0.05).The overall response of CD44+/CD24-/lowpositive group was higher but had no difference compared with CD44+/CD24-/low negative group (75% vs.69.1%,P=0.542),and the rate of pathological complete remission (pCR) in CD44+/CD24-/lowpositive group was higher than that in CD44+/CD24-/lownegative group (38.9% vs.18.2%,P=0.028). Conclusion CD44+/CD24-/low cells are demonstrated in certain breast cancer,CD44＋/CD24－/low phenotype is associated with triple negative breast cancer and the responsiveness of breast cancer to anthracycline-based chemotherapy.CD44＋/CD24 －/low phenotype may be used as one of the indicators to evaluate the clinical chemotherapeutic response of the patients with breast cancer.
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Key words:
- 乳腺癌 /
- CD44＋/CD24－/low表型 /
- 三阴性 /
- 化疗敏感度
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