Xu Chenpu, Wei Qun, Guo Jufeng, Zhou Ji Chun, Mei Jin, Jiang Zhi Nong, Shen Jian Guo, Wang Lin Bo
Department of Surgical Oncology, Affiliated Sir Run Run Shaw Hospital, Zhejiang University, Hangzhou, Zhejiang, People's Republic of China.
Ann Surg Oncol. 2015;22(6):2034-9. doi: 10.1245/s10434-014-4313-2. Epub 2015 Feb 24.
Most estrogen receptor (ER)-positive breast cancer responds poorly to chemotherapy and no single cost-effective biomarker capable of selecting chemosensitive ones has been found yet. We investigated FOXA1 for its role in predicting chemosensitivity of this subgroup in neoadjuvant chemotherapy settings.
We reviewed pathologic slides of 123 patients who were diagnosed with ER-positive breast cancer on core needle biopsy and underwent neoadjuvant chemotherapy at our institution between 2002 and 2012. FOXA1 expression and pathologic response were evaluated. We then statistically analyzed FOXA1 expression and its relationship with chemosensitivity.
FOXA1 expression before NAC was correlated with poor chemoresponse in ER-positive as well as luminal A and luminal B breast cancer patients (p = 0.002, 0.001, and 0.049 respectively). Significant association between change of FOXA1 staining position after NAC and chemosensitivity also was observed (p = 0.024). Multivariate analysis identified FOXA1 expression before NAC as an independent predictor of chemosensitivity in ER-positive and luminal A breast cancer patients [p = 0.002; relative risk (RR) 0.163; 95 % confidence interval (CI) 0.053-0.500, and p = 0.002; RR 0.055; 95 % CI 0.008-0.353, respectively]. Additionally, change of FOXA1 staining position after NAC was shown to be an independent predictor of chemoresponse in luminal B subtype breast cancer patients (p = 0.012; RR 0.153; 95 % CI 0.035-0.665).
FOXA1 expression can independently predict chemosensitivity of ER-positive breast cancer patients.
大多数雌激素受体（ER）阳性乳腺癌对化疗反应不佳，目前尚未发现单一的、具有成本效益的生物标志物能够筛选出化疗敏感的患者。我们研究了叉头框蛋白A1（FOXA1）在新辅助化疗背景下预测该亚组化疗敏感性中的作用。
我们回顾了123例患者的病理切片，这些患者经粗针穿刺活检诊断为ER阳性乳腺癌，并于2002年至2012年在我院接受新辅助化疗。评估了FOXA1表达和病理反应。然后对FOXA1表达及其与化疗敏感性的关系进行统计学分析。
新辅助化疗（NAC）前FOXA1表达与ER阳性以及腔面A型和腔面B型乳腺癌患者化疗反应差相关（分别为p = 0.002、0.001和0.049）。还观察到NAC后FOXA1染色位置变化与化疗敏感性之间存在显著关联（p = 0.024）。多因素分析确定NAC前FOXA1表达是ER阳性和腔面A型乳腺癌患者化疗敏感性的独立预测因子[p = 0.002；相对危险度（RR）0.163；95%置信区间（CI）0.053 - 0.500，以及p = 0.002；RR 0.055；95% CI 0.008 - 0.353]。此外，NAC后FOXA1染色位置变化被证明是腔面B亚型乳腺癌患者化疗反应的独立预测因子（p = 0.012；RR 0.153；95% CI 0.035 - 0.665）。
FOXA1表达可独立预测ER阳性乳腺癌患者的化疗敏感性。
