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中华乳腺病杂志(电子版)

中华乳腺病杂志(电子版) ›› 2013, Vol. 07 ›› Issue (04) : 259 -262. doi: 10.3877/cma. j. issn.1674-0807.2013.04.005

论著

S 期细胞比率对乳腺癌新辅助化疗敏感性的预测价值
张景臣1, 毛大华2,†()   
  1. 1.450000 郑州,郑州人民医院乳腺科
    2.550004 贵阳,贵州省贵阳医学院第一附属医院乳腺外科
  • 收稿日期:2013-01-06 出版日期:2013-08-01
  • 通信作者: 毛大华

Predictive value of S-phase fraction on the sensitivity of breast cancer patients to neoadjuvant chemotherapy

Jing-cheng ZHANG1, Da-hua MAO1,†()   

  1. 1.Department of Breast Disease, People’ s Hospital of Zhengzhou, Zhengzhou 450000, China
  • Received:2013-01-06 Published:2013-08-01
  • Corresponding author: Da-hua MAO
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张景臣, 毛大华. S 期细胞比率对乳腺癌新辅助化疗敏感性的预测价值[J/OL]. 中华乳腺病杂志(电子版), 2013, 07(04): 259-262.

Jing-cheng ZHANG, Da-hua MAO. Predictive value of S-phase fraction on the sensitivity of breast cancer patients to neoadjuvant chemotherapy[J/OL]. Chinese Journal of Breast Disease(Electronic Edition), 2013, 07(04): 259-262.

目的

探讨乳腺癌细胞S 期细胞比率(SPF)能否作为乳腺癌新辅助化疗敏感性的预测因子。

方法

通过流式细胞仪检测2006 年1 月至2010 年11 月贵阳医学院第一附属医院乳腺外科收治的66 例乳腺癌患者新辅助化疗前后乳腺癌组织中细胞SPF 的变化,并比较SPF 与临床病理特征之间的关系,统计分析采用配对资料的t 检验及秩和检验。

结果

在66 例患者中,新辅助化疗疗效评价为6 例病理完全缓解(pCR),41 例部分缓解(PR),17 例病情稳定(SD),2 例疾病进展(PD)。 41 例PR 患者的SPF 新辅助化疗前为(7.69±4.67)%,新辅助化疗后为(5.58±4.61)%,差异有统计学意义(t=2.314, P=0.026)。 19 例化疗无效的患者(包括SD、PD)新辅助化疗前SPF 为(4.52±3.30)%,新辅助化疗后SPF 为(4.19±3.01)%,差异无统计学意义(t=0.50,P=0.623)。 47 例客观缓解的患者(包括pCR、CR、PR)新辅助化疗前的SPF 为(7.26±4.53)%,与19 例化疗无效的患者新辅助化疗前的SPF[(4.52±3.30)%]比较, 差异有统计学意义(t=2.394,P=0.020)。 新辅助化疗前癌灶的SPF 与患者年龄、月经状况无明显关系(Z=-1.461,-1.097;P＞0.05), 而与肿瘤直径、临床分期、淋巴结转移有关(χ2=8.258,11.920;Z=-2.194;P＜0.05)。

结论

新辅助化疗对乳腺癌细胞S 期的影响是明显的,可以降低乳腺癌细胞的增殖,SPF 值较大者对化疗敏感。

关键词: 乳腺肿瘤, 流式细胞术, 化学疗法, 辅助, 细胞周期

Objective

To evaluate whether S-phase fraction(SPF) can be used as a sensitive predictor for neoadjuvant chemotherapy in breast cancer patients.

Methods

The SPF change of breast cancer tissues from 66 breast cancer patients treated in Department of Breast Surgery, the First Affiliated Hospital of Guiyang Medical College, between January 2006 and November 2010 was detected by flow cytometry before and after neoadjuvant chemotherapy. Paired t test was used to analyze the change of SPF, and rank sum test was used to determine the relationship between SPF and clinical pathological characteristics.

Results

In all 66 cases, after neoadjuvant chemotherapy, there were 6 cases evaluated with complete pathologic response (pCR), 41 with partial response (PR),17 with stable disease (SD) and 2 with progressive disease (PD). In 41 patients with PR, SPF was (7.69±4.67)% before chemotherapy, (5.58±4.61)% after chemotherapy, respectively, and the difference was statistically significant (t=2.314, P=0.026). In 19 patients with PD plus SD, SPF was(4.52±3.30)% before chemotherapy, (4.19±3.01)% after chemotherapy, respectively, which indicated no statistically significant difference (t=2.314, P=0.026). SPF in the 47 patients with remission (including pCR, CR, PR) was (4.52±3.30)% before chemotherapy, which was statistically different from that in the 19 patients with PD plus SD before chemotherapy [(4.19±3.01)%] (t=2.314, P=0.026). SPF of breast cancer tissue before neoadjuvant chemotherapy was related with tumor diameter, clinical stage and lymph node metastasis (F = 8.258,11.920;Z = -2.194; P ＜0.05), but with no correlation with patients’ age and menstruation status(Z = -1.461,-1.097;P ＞0.05).

Conclusion

The neoadjuvant chemotherapy has a remarkable influence on S phase of breast cancer cells and it can decrease cell proliferation,implicating that the patients with higher SPF may be more sensitive to chemotherapy.

Key words: Breast neoplasms, Flow cytometry, Chemotherapy, adjuvant, Cell cycle
表1 新辅助化疗前癌灶的SPF 与临床病理特征之间的关系
临床病理特征 例数 SPF(%,x¯±s) 检验值 P值
年龄 -1.461a 0.144
＜50 岁 39 6.15±3.98
≥50 岁 27 7.71±4.76
月经状况 -1.097a 0.273
绝经前 41 6.32±3.99
绝经后 25 7.56±4.93
肿瘤直径 8.258b 0.016
≤2 cm 8 3.15±3.81
＞2 cm～5 cm 39 7.33±4.59
＞5 cm 19 7.20±3.39
淋巴结转移 -2.194a 0.028
有 34 7.86±4.41
无 32 5.66±4.06
临床分期 11.920b 0.003
Ⅰ 6 1.76±1.12
Ⅱ 49 7.16±4.35
Ⅲ 11 7.90±3.82
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