Department of Oncology and Pathology, Hospital São Lucas, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre-RS, Brazil.
Clin Breast Cancer. 2011 Apr;11(2):129-34. doi: 10.1016/j.clbc.2011.03.002. Epub 2011 Apr 11.
Predictive biomarkers of response to neoadjuvant chemotherapy in patients with breast cancer are needed to better characterize tumors and enable more tailored therapies.
The expression levels of survivin, BCL-2, cyclin D1, ETS1, and PDEF in tumor samples obtained in the diagnostic biopsies of patients undergoing neoadjuvant chemotherapy for stage II and stage III disease were evaluated by immunohistochemistry (IHC). The mean expression score (range, 0-15) obtained by 3 different pathologists was used for analysis and correlated with complete pathologic response (pCR) and survival by standard univariate and multivariate methods.
Forty-five female patients were included in this study and received preoperative standard anthracycline/taxane-based chemotherapy. The median age at diagnosis was 49 years (range, 25-70 years). Three patients (7.1%) achieved pCR. The mean expression score of survivin in the diagnostic biopsies was significantly higher (P = .01) in patients with pCR (9.3) than in those without (3.4). There was no significant association with pCR for the other biologic markers analyzed nor was there correlation with prognosis. Survivin levels were not associated with age, tumor grade, clinical stage, or receptor status.
High expression levels of survivin in the primary tumor may be used as a potential predictive biomarker of pCR to neoadjuvant chemotherapy in patients with stage II and stage III breast cancer.
需要预测生物标志物来预测乳腺癌患者对新辅助化疗的反应，以便更好地对肿瘤进行特征描述，并实现更具针对性的治疗。
通过免疫组织化学（IHC）检测接受新辅助化疗的 II 期和 III 期疾病患者的诊断性活检肿瘤样本中生存素、BCL-2、细胞周期蛋白 D1、ETS1 和 PDEF 的表达水平。由 3 位不同病理学家获得的平均表达评分（范围 0-15）用于分析，并通过标准单变量和多变量方法与完全病理缓解（pCR）和生存相关联。
本研究共纳入 45 名女性患者，接受术前标准蒽环类药物/紫杉烷类为基础的化疗。诊断时的中位年龄为 49 岁（范围 25-70 岁）。3 名患者（7.1%）达到 pCR。pCR 患者（9.3）的诊断性活检中生存素的平均表达评分明显高于无 pCR 患者（3.4）（P =.01）。其他分析的生物标志物与 pCR 无显著相关性，也与预后无相关性。生存素水平与年龄、肿瘤分级、临床分期或受体状态无关。
原发性肿瘤中生存素的高表达水平可能可用作 II 期和 III 期乳腺癌患者对新辅助化疗 pCR 的潜在预测生物标志物。
