Yang Qifeng, Sakurai Takeo, Yoshimura Goro, Suzuma Takaomi, Umemura Teiji, Nakamura Misa, Nakamura Yasushi, Mori Ichiro, Kakudo Kennichi
Department of General Surgery, Qilu Hospital, Shandong University, Ji'nan, Shandong Province, PR China.
Oncol Rep. 2003 Jan-Feb;10(1):121-5.
Apoptosis induced by anticancer agents is a mechanism of treatment activity, overexpression of antiapoptotic genes could produce drug resistant tumors. We have demonstrated that the susceptibility of Bcl-2-negative tumors to a series of anticancer drugs was significantly higher than that of Bcl-2-positive tumors. The purpose of this study was to examine if negative Bcl-2 expression has treatment benefit in breast cancer patients received chemotherapy and endocrine treatment. A cohort of 147 Japanese women with invasive ductal carcinoma was studied. All the patients received postoperative adjuvant therapy consisting of combination chemotherapy with cyclophosphamide, epirubicin, and fluorouracil, and tamoxifen therapy. The expression of Bcl-2, estrogen receptor (ER) and MIB-1 was evaluated in breast cancer surgical specimens. Bcl-2 immunostaining was inversely correlated with increasing histologic grade (p=0.0095) and MIB-1 (p=0.0128). Furthermore, a positive correlation between Bcl-2 and ER was observed (p<0.0001). Unexpectedly, survival curves determined by the Kaplan-Meier method and univariate analysis demonstrated that Bcl-2-positivity was associated with favorable prognosis (p=0.0430). Cox proportional hazard model demonstrated that positive Bcl-2 expression still has favorable survival (p=0.0242) after consideration of other prognostic factors. Our results imply that Bcl-2 is a significant favorable prognostic factor for breast cancer with chemotherapy and endocrine therapy.
抗癌药物诱导的细胞凋亡是一种治疗活性机制，抗凋亡基因的过表达可产生耐药肿瘤。我们已经证明，Bcl-2阴性肿瘤对一系列抗癌药物的敏感性显著高于Bcl-2阳性肿瘤。本研究的目的是检验Bcl-2阴性表达在接受化疗和内分泌治疗的乳腺癌患者中是否具有治疗益处。对147名患有浸润性导管癌的日本女性进行了队列研究。所有患者均接受了由环磷酰胺、表柔比星和氟尿嘧啶联合化疗以及他莫昔芬治疗组成的术后辅助治疗。在乳腺癌手术标本中评估了Bcl-2、雌激素受体（ER）和MIB-1的表达。Bcl-2免疫染色与组织学分级增加（p = 0.0095）和MIB-1（p = 0.0128）呈负相关。此外，观察到Bcl-2与ER之间存在正相关（p < 0.0001）。出乎意料的是，通过Kaplan-Meier方法和单因素分析确定的生存曲线表明，Bcl-2阳性与良好的预后相关（p = 0.0430）。Cox比例风险模型表明，在考虑其他预后因素后，Bcl-2阳性表达仍具有良好的生存率（p = 0.0242）。我们的结果表明，Bcl-2是接受化疗和内分泌治疗的乳腺癌的一个重要的良好预后因素。
