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Expression of Chemokine Receptor CXCR4 in Locally Advanced Breast Cancer Patients with the Efficacy and Prognosis Correlation of Neoadjuvant Chemotherapy

Author: YangYongDe
Tutor: ZengXiaoHua
School: Chongqing Medical University
Course: Surgery
Keywords: Breast Cancer Chemokine receptor CXCR4 Neoadjuvant chemotherapy
CLC: R737.9
Type: Master's thesis
Year: 2011
Downloads: 22
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Abstract


Background and purpose of the chemokine receptor CXCR4 (CXC Chemokine Receptor 4) is a seven-transmembrane G protein-coupled receptor, has been confirmed with a variety of cancers, including breast cancer invasion and metastasis. Many scholars of CXCR4 expression and breast cancer neoadjuvant chemotherapy and prognostic factors relationship between research, but has not yet formed a unified conclusion. This study was designed to compare neoadjuvant chemotherapy before and after the relationship between the expression of CXCR4 and neoadjuvant chemotherapy and prognosis, to investigate CXCR4 whether neoadjuvant chemotherapy and prognosis effective index as a predictor. Received four cycles of paclitaxel combined anthracycline neoadjuvant chemotherapy in the treatment of 86 cases II of b ~~ Ⅲ b (with reference to 2002, the sixth edition AJCC breast cancer TNM staging) LABC patient data were retrospectively analyzed, including invasive ductal cancer, 52 cases, 20 cases of invasive lobular carcinoma, carcinoma simplex six cases, four cases of hard cancer, medullary carcinoma 4 cases. Detected by immunohistochemistry method before and after neoadjuvant chemotherapy in breast cancer tissue expression of CXCR4, the analysis of neoadjuvant chemotherapy the clinical pathology efficacy of CXCR4 expression and its relationship with the long-term survival. Χ ~ 2 test or Fisher's exact method to analyze the expression of CXCR4 and neoadjuvant chemotherapy clinical, pathological efficacy, Kaplan-Meier method and Cox proportional hazards regression model analysis of patient survival situation, comparison with the log-rank test to compare survival. Results in 58 of 86 cases (67.4%) cases for the CXCR4 high expression, 28 (32.6%) cases showed low expression neoadjuvant chemotherapy, CXCR4 high expression of the 49 (57.0%) patients, and low expression of the 37 (43.0%) patients, the new before and after adjuvant chemotherapy the CXCR4 expression changes differences statistically significant (χ ~~ 2 = 1.00, P gt; 0.05). 86 patients the primary tumor foci total response rate (OR) was 90.7% (78? 86) to which clinical complete remission (CCR), 20.9% (18? 86), partial remission (PR), 69.8% (60? 86) stable disease (SD) 9.3% (8? 86), pathologic complete response (pCR) 15.1% (13? 86). CXCR4 low expression obtained cCR accounted for 39.3% (11? 28), obtained pCR accounted for 28.6% (8? 28), significantly higher than the CXCR4 high expression obtained cCR12.07% (7? 58), pCR8.6% ( 5? 58) (P lt; 0.05). After neoadjuvant chemotherapy, CXCR4 high expression of the 5-year recurrence-free survival (RFS) of 34%, lower than the the CXCR4 low expression group (59%), (P = 0.0027), CXCR4 high expression of the 5-year overall survival (OS) 57%, lower than the CXCR4 low expression group (68%) (P = 0.0139). LABC patients CXCR4 high expression of the relative risk of relapse and death of CXCR4 low expression of 2.923 (95% CI = 1.418-6.023; P = 0.0036) times and 3.364 (95% CI = 1.190-9.509 P = 0.0221) times the combined COX regression analysis, high expression of CXCR4 is a LABC patients after neoadjuvant chemotherapy independent prognostic indicators. Conclusion paclitaxel plus anthracycline neoadjuvant chemotherapy in LABC neoadjuvant chemotherapy in efficacy was significantly low, CXCR4 expression efficacy is more pronounced, to and more accessible cCR and pCR. , CXCR4 high expression of long-term survival after neoadjuvant chemotherapy was significantly lower than the low CXCR4 expression, the risk of recurrence and death. CXCR4 can be used as an important reference index to predict response to neoadjuvant chemotherapy and prognosis.

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