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乳腺癌新辅助化疗后99mTcMIBI显像与残余肿瘤CerbB-2、BCl-2、PCNA、nm23与P53蛋白的关系
http://www.100md.com 《中华现代影像学杂志》 2006年第12期
乳腺癌；新辅助化疗；甲氧基异丁基异腈；免疫组织化学；癌基因,,],乳腺癌；新辅助化疗；甲氧基异丁基异腈；免疫组织化学；癌基因,1资料与方法,2结果,3讨论,[参考文献]
     [摘要] 目的 探讨新辅助化疗后99mTcMIBI摄取与残余乳腺癌相关癌基因蛋白的关系。方法 病理学证实的乳腺癌患者50例，给予环磷酰胺+甲氨蝶呤+5氟尿嘧啶3个疗程或环磷酰胺+表阿霉素+5氟尿嘧啶2个疗程治疗，4周后进行99mTcMIBI显像，计算99mTcMIBI早期(10 min)、晚期(2 h)显像肿瘤部位与对侧相应部位最大放射性计数比值及清除率即T/N(e)、T/N(d)、WR。手术切除残余乳腺癌组织，免疫组化法分析CerbB-2、BCl-2、PCNA、nm23、P53蛋白水平。结果 残余乳腺癌99mTcMIBI的T/N(e)值在CerbB-2阳性组明显高于阴性组(Z=1.98，P=0.048)、在CerbB-2强阳性组明显高于弱阳性或阴性组(Z=2.03、P=0.04)、在PCNA阳性组明显高于阴性组(Z=2.76，P=0.006)、在BCl-2强阳性组明显低于弱阳性或阴性组(Z=1.98，P=0.048)。T/N(d)及WR在上述各组间差异均无显著性。残余乳腺癌99mTcMIBI的T/N(e)、T/N(d)、WR值与nm23、P53蛋白水平未见相关(均P>0.05)。结论 乳腺癌新辅助化疗后99mTcMIBI显像可评估残余肿瘤预后因子、增殖活性及抗凋亡状态，为估计预后和术后治疗提供参考。

    [关键词] 乳腺癌；新辅助化疗；甲氧基异丁基异腈；免疫组织化学；癌基因

    Correlation between residual tumor uptake of 99mTcmethoxyisobutylisonitrileafter neoadjuvant chemotherapy and expression of CerbB-2,BCl-2,PCNA,nm23 and P53 in breast cancer

    GUAN Yanxing,LEI Qiumo,Qu Wei,et al.Department of Nuclear Medicine，the First Affiliated Hospital of Nanchang University,Nanchang 330006，China

    [Abstract] Objective To study the correlation between uptake of 99mTcmethoxyisobutylisonitrile (MIBI) and expression of CerbB-2，BCl-2，PCNA，nm23 and P53 in residual breast cancer after neoadjuvant chemotherapy. Methods Fifty patients with histopathology proven breast carcinoma underwent the neoajuvant chemotherapy (three courses of treatment:cyclophosphamide + methotrexate + 5-fluorouracil,or two courses of treatment:cyclophosphamide + epirubicin+ 5-fluorouracil).Anterior planar imagings were acquired respectively at 10 and 120 minutes after injection of 99mTc MIBI and the tumortonormal breast ratios and washout rate were calculated [respectively called T/N(e),T/N(d)and WR].The expressions of CerbB-2,BCl-2,PCNA,nm23 and P53 in surgically removed breast cancerwere assessed with immunohistochemistry. Results The T/N(e) ratios were significantly increasing in CerbB-2 positive group and strong positive group respectively than in the negative group and weak positive or negative group(Z=1.98,P=0.048,Z=2.03,P=0.04 respectively),in PCNA positive group than in negative group(Z=2.76 ......

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