Prognostic significance of bcl-2 expression in stage III breast cancer patients who had received doxorubicin and cyclophosphamide followed by paclitaxel as adjuvant chemotherapy.
Prognostic significance of bcl-2 expression in stage III breast cancer patients who had received doxorubicin and cyclophosphamide followed by paclitaxel as adjuvant chemotherapy.
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DOI：
10.1186/1471-2407-7-63
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发表时间：
2007-04-12
期刊：
影响因子：
3.8
通讯作者：
Bang YJ
中科院分区：
文献类型：
--
作者：
Lee KH;Im SA;Oh DY;Lee SH;Chie EK;Han W;Kim DW;Kim TY;Park IA;Noh DY;Heo DS;Ha SW;Bang YJ
Bcl-2在乳腺癌中受到激素受体途径的正调控。进行了一项研究，以评估临床病理变量和ER，PR，p53，c-erbB 2，bcl-2，或Ki-67作为乳腺癌患者复发标志物的预后意义，这些患者在同一个机构接受了相同的辅助治疗。对151例根治性切除的III期乳腺癌患者（男：女= 3：148，中位年龄46岁）进行临床病理特征分析，这些患者有4个或更多阳性淋巴结，接受阿霉素和环磷酰胺，随后接受紫杉醇（AC/T）作为辅助化疗，包括无病生存期（DFS）和总生存期（OS）。ER和/或PR表达阳性的患者在AC/T后接受了5年的他莫昔芬治疗。生物标志物的蛋白质表达进行了化学评价。中位随访时间为36个月，37例患者（24.5%）复发。单因素分析显示肿瘤大小（P = 0.038）和淋巴结转移（P < 0.001）对复发有显著影响。然而，手术类型、组织学、组织学分级、内淋巴管栓塞的存在和近切缘并不影响。ER阳性（P = 0.013）、bcl-2阳性（P = 0.002）和p53低表达（P = 0.032）与DFS延长显著相关。多因素分析显示10个或更多淋巴结受累（HR 7.366; P < 0.001）、bcl-2阴性表达（HR 2.895; P = 0.030）和c-erbB 2过表达（HR 3.535; P = 0.001）是DFS较差的独立指标。bcl-2表达与ER、PR表达呈显著相关，与p53、c-erbB 2、Ki-67表达呈负相关。bcl-2阳性表达者DFS明显长于阴性表达者，即使在ER（+）亚组中也是如此。ER、bcl-2和c-erbB 2对OS有显著影响。Bcl-2是根治性切除的III期乳腺癌患者DFS的独立预后因素，与c-erbB 2和受累淋巴结数量联合似乎是一个有用的预后因素。
Bcl-2 is positively regulated by hormonal receptor pathways in breast cancer. A study was conducted to assess the prognostic significances of clinico-pathologic variables and of ER, PR, p53, c-erbB2, bcl-2, or Ki-67 as markers of relapse in breast cancer patients who had received the identical adjuvant therapy at a single institution. A cohort of 151 curatively resected stage III breast cancer patients (M:F = 3:148, median age 46 years) who had 4 or more positive lymph nodes and received doxorubicin and cyclophosphamide followed by paclitaxel (AC/T) as adjuvant chemotherapy was analyzed for clinico-pathologic characteristics including disease-free survival (DFS) and overall survival (OS). Patients with positive ER and/or PR expression received 5 years of tamoxifen following AC/T. The protein expressions of biomarkers were assessed immunohistochemically. The median follow-up duration was 36 months, and 37 patients (24.5%) experienced a recurrence. Univariate analyses indicated that the tumor size (P = 0.038) and the number of involved lymph nodes (P < 0.001) significantly affected the recurrences. However, the type of surgery, the histology, histologic grade, the presence of endolymphatic emboli, and a close resection margin did not. Moreover, ER positivity (P = 0.013), bcl-2 positivity (P = 0.002) and low p53 expression (P = 0.032) were found to be significantly associated with a prolonged DFS. Furthermore, multivariate analysis identified 10 or more involved lymph nodes (HR 7.366; P < 0.001), negative bcl-2 expression (HR 2.895; P = 0.030), and c-erbB2 over-expression (HR 3.535; P = 0.001) as independent indicators of poorer DFS. In addition, bcl-2 expression was found to be significantly correlated with the expressions of ER and PR, and inversely correlated with the expressions of p53, c-erbB2 and Ki-67. Patients with bcl-2 expression had a significantly longer DFS than those without, even in the ER (+) subgroup. Moreover, OS was significantly affected by ER, bcl-2 and c-erbB2. Bcl-2 is an independent prognostic factor of DFS in curatively resected stage III breast cancer patients and appears to be a useful prognostic factor in combination with c-erbB2 and the number of involved lymph nodes.
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影响因子：
158.5
作者：
Martin, M;Pienkowski, T;Vogel, C
通讯作者：
Vogel, C
影响因子：
8.8
作者：
vanSlooten, HJ;Clahsen, PC;vandeVijver, MJ
通讯作者：
vandeVijver, MJ
影响因子：
45.3
作者：
Henderson, IC;Berry, DA;Norton, L
通讯作者：
Norton, L
影响因子：
3.6
作者：
Ferlini, C;Raspaglio, G;Scambia, G
通讯作者：
Scambia, G
影响因子：
158.5
作者：
van de Vijver, MJ;He, YD;Bernards, R
通讯作者：
Bernards, R