Hajduk Magdalena, Olszewski Wojciech P, Smietana Anetta
Diagnostic Centre "PATOLOG", Rzeszów.
Pol J Pathol. 2009;60(3):115-23.
Although the increasing body of knowledge in the field of immunohistochemistry and molecular biology has allowed for better understanding of the biology of breast cancer; nevertheless, a search is still in progress for new factors that would make it possible to preselect patients and employ target therapies. Predictive factors that arouse interest include topoisomerases. The authors evaluated the response to treatment and survival rates depending on expression of topoisomerase II alpha (TOP2A) and other predictive factors, as well as assessed treatment effectiveness employing therapeutic schemes based on anthracycline depending on TOP2A expression. The investigations demonstrated that the response to treatment and survival of patients with TOP2A expression were similar to the response and survival of those with tumours demonstrating the presence of other recognized predictors. The employed adjuvant therapy according to anthracycline therapeutic protocols was markedly more effective in TOP2A-positive patients as compared to the remaining individuals. Thus, TOP2A constituted a predictive factor. The study demonstrated that in adjuvant therapy employed in infiltrating ductal carcinoma of the breast, not only HER2 but also TOP2A determination in cancer cells was of importance; for this reason, routine determinations by immunohistochemistry should be performed, especially when anthracycline treatment is planned.
尽管免疫组织化学和分子生物学领域日益丰富的知识使人们对乳腺癌生物学有了更好的理解；然而，仍在寻找能够对患者进行预筛选并采用靶向治疗的新因素。引起关注的预测因素包括拓扑异构酶。作者根据拓扑异构酶IIα（TOP2A）的表达及其他预测因素评估了治疗反应和生存率，并根据TOP2A表达情况评估了采用基于蒽环类药物治疗方案的治疗效果。研究表明，TOP2A表达阳性患者的治疗反应和生存率与存在其他公认预测指标的肿瘤患者的反应和生存率相似。与其他个体相比，根据蒽环类治疗方案采用的辅助治疗在TOP2A阳性患者中明显更有效。因此，TOP2A构成了一个预测因素。该研究表明，在乳腺癌浸润性导管癌的辅助治疗中，不仅HER2，而且癌细胞中TOP2A的检测也很重要；因此，应通过免疫组织化学进行常规检测，尤其是在计划进行蒽环类药物治疗时。
