Liu Yushi, Kang Ye, Li Jianyi, Zhang Yang, Jia Shi, Sun Qiang, Ma Yan, Zhang Jing, Wang Zhenrong, Cao Yanan, Shen Yang
Department of Breast Surgery, ShengJing Hospital of China Medical University, Shenyang, China.
Department of Pathology, Shengjing Hospital of China Medical University, Shenyang, China.
Front Oncol. 2022 Jun 30;12:630065. doi: 10.3389/fonc.2022.630065. eCollection 2022.
It is well-known that the pathological complete response (pCR) rate in patients with luminal A cancer (LAC) is lower than those of other subtypes of breast cancer. The phenotype of cancer often alters after neoadjuvant chemotherapy (NAC) which may be related to hypoxia, and the latter might induce the drift of the estrogen receptor (ER). The phenotype drift in local advanced LAC after NAC might influence the long-term prognosis.
The oxygen concentration of cancer tissues during NAC was recorded and analyzed (n = 43). The expression of ER and claudin-6 was detected in pre- and post-NAC specimens.
NAC might induce the cycling intracanceral hypoxia, and the pattern was related to NAC response. The median follow-up time was 61 months. Most of the patients (67%) with stable or increased ER and claudin-6 expression exhibited perfect prognosis (DFS = 100%, 61 months). About 20% of patients with decreased claudin-6 would undergo the poor prognosis (DFS = 22.2%, 61 months). The contrasting prognosis (100% vs. 22.2%) had nothing to do with the response of NAC in the above patients. Only 13% patients had stable claudin-6 and decreased ER, whose prognosis might relate to the response of NAC.
NAC might induce cycling intracanceral hypoxia to promote the phenotype drift in local advanced LAC, and the changes in ER and claudin-6 after NAC would determine the long-term prognosis.
众所周知，腔面A型乳腺癌（LAC）患者的病理完全缓解（pCR）率低于其他亚型的乳腺癌。新辅助化疗（NAC）后癌症的表型常发生改变，这可能与缺氧有关，而缺氧可能诱导雌激素受体（ER）的漂移。NAC后局部晚期LAC的表型漂移可能影响长期预后。
记录并分析NAC期间癌组织的氧浓度（n = 43）。在NAC前后的标本中检测ER和claudin-6的表达。
NAC可能诱导癌内周期性缺氧，且这种模式与NAC反应相关。中位随访时间为61个月。大多数ER和claudin-6表达稳定或增加的患者（67%）预后良好（无病生存期[DFS]=100%，61个月）。约20%的claudin-6表达降低的患者预后较差（DFS = 22.2%，61个月）。上述患者中这种截然不同的预后（100%对22.2%）与NAC的反应无关。只有13%的患者claudin-6稳定而ER降低，其预后可能与NAC的反应有关。
NAC可能诱导癌内周期性缺氧，从而促进局部晚期LAC的表型漂移，NAC后ER和claudin-6的变化将决定长期预后。
