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血清抗p53抗体、癌胚抗原、糖类抗原15-3、雌激素受体、孕激素受体及人表皮生长因子受体-2在局部晚期乳腺癌患者紫杉类和蒽环类新辅助化疗中的预测价值

Predictive value of serum anti-p53 antibodies, carcino-embryonic antigen, carbohydrate antigen 15-3, estrogen receptor, progesterone receptor and human epidermal growth factor receptor-2 in taxane-based and anthracycline-based neoadjuvant chemotherapy in locally advanced breast cancer patients.

作者信息

Bao Huizheng, Yu Dehai, Wang Jun, Qiu Tian, Yang Jianli, Wang Li

机构信息

Institute of Genetics and Cytology, School of Life Sciences, Northeast Normal University, Changchun, Jilin Province, PR China.

出版信息

Anticancer Drugs. 2008 Mar;19(3):317-23. doi: 10.1097/cad.0b013e3282f3d018.

Abstract

Breast carcinoma is the most common malignancy in Chinese women. The purpose of this study is to evaluate the predictive value of serum anti-p53 antibodies (p53 Abs), carcino-embryonic antigen (CEA), carbohydrate antigen (CA) 15-3, estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor (HER)-2 in taxane-based and anthracycline-based neoadjuvant chemotherapy (NAC). Sixty-eight patients with locally advanced breast carcinoma were included. Thirty-two were treated with taxane (the taxane group) and 36 with anthracycline (the anthracycline group). The standard dosage of docetaxel was 100 mg/m2 (day 1) and those of cyclophosphamide, adriamycin and 5-flurouracil were 500 mg/m2 (day 1-8), 40 mg/m2 (day 1) and 500 mg/m2 (day 1-8), respectively. The p53 Abs were detected by enzyme-linked immunosorbent assay; CEA and CA15-3 were detected by Elecsys 2010 Disc System; ER, PR and HER-2 were detected by immunohistochemistry staining. The biomarkers p53 Abs, CEA and CA15-3 were detected in serum samples, and the immunohistochemistry staining for ER, PR and HER-2 was performed in tumor samples before and after NAC. The expression of p53 Abs was significantly reduced by taxane (P = 0.006). The serum CEA and CA15-3 levels were significantly affected by both taxane (P = 0.004 and P = 0.008) and anthracycline (P = 0.002 and P = 0.000) drugs. HER-2-negative status (pre-neoadjuvant) was correlated with a high objective response rate (OR) in both taxane-based and anthracycline-based chemotherapy (P = 0.022 and P = 0.025), whereas p53 Ab-negative status (pre-neoadjuvant) was correlated with high OR rate in anthracycline-based chemotherapy (P = 0.039). This study shows that the serum p53 Ab level is easily changed by taxane. CEA and CA15-3 levels are easily changed by taxane and anthracycline. The p53 Ab-negative patients may predict a high clinical OR rate in anthracycline-based NAC. HER-2-negative may predict a high OR in both taxane-based and anthracycline-based NAC.

摘要

乳腺癌是中国女性中最常见的恶性肿瘤。本研究的目的是评估血清抗p53抗体(p53 Abs)、癌胚抗原(CEA)、糖类抗原(CA)15 - 3、雌激素受体(ER)、孕激素受体(PR)和人表皮生长因子受体(HER)- 2在紫杉烷类和蒽环类新辅助化疗(NAC)中的预测价值。纳入了68例局部晚期乳腺癌患者。32例接受紫杉烷治疗(紫杉烷组),36例接受蒽环类治疗(蒽环类组)。多西他赛的标准剂量为100 mg/m²(第1天),环磷酰胺、阿霉素和5 - 氟尿嘧啶的标准剂量分别为500 mg/m²(第1 - 8天)、40 mg/m²(第1天)和500 mg/m²(第1 - 8天)。通过酶联免疫吸附测定法检测p53 Abs;通过Elecsys 2010 Disc系统检测CEA和CA15 - 3;通过免疫组织化学染色检测ER、PR和HER - 2。在NAC前后,在血清样本中检测生物标志物p53 Abs、CEA和CA15 - 3,并在肿瘤样本中进行ER、PR和HER - 2的免疫组织化学染色。紫杉烷可显著降低p53 Abs的表达(P = 0.006)。紫杉烷(P = 0.004和P = 0.008)和蒽环类药物(P = 0.002和P = 0.000)均显著影响血清CEA和CA15 - 3水平。在基于紫杉烷类和蒽环类的化疗中,HER - 2阴性状态(新辅助治疗前)与高客观缓解率(OR)相关(P = 0.022和P = 0.025);而在基于蒽环类的化疗中,p53 Ab阴性状态(新辅助治疗前)与高OR率相关(P = 0.039)。本研究表明,血清p53 Ab水平易受紫杉烷影响。CEA和CA15 - 3水平易受紫杉烷和蒽环类影响。p53 Ab阴性患者在基于蒽环类的NAC中可能预示着高临床OR率。HER - 2阴性在基于紫杉烷类和蒽环类的NAC中可能预示着高OR率。

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