Differences in prognosis and efficacy of chemotherapy by p53 expression in triple-negative breast cancer
Differences in prognosis and efficacy of chemotherapy by p53 expression in triple-negative breast cancer
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DOI：
10.1007/s10549-018-4928-2
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发表时间：
2018-11-01
影响因子：
3.8
通讯作者：
Jung, Seung Pil
中科院分区：
文献类型：
--
作者：
Bae, Soo Youn;Nam, Seok Jin;Jung, Seung Pil
目的TP 53突变是乳腺癌中最常见的突变，被认为是三阴性乳腺癌（triple-negative breast cancer，TNBC）的靶标记。我们研究了是否通过免疫化学染色检测p53的表达预测TNBC.MethodsA的化疗反应，共11,393 TNBC患者谁参加了第一阶段和第三阶段之间的韩国乳腺癌协会登记数据库从2000年1月1日至2015年12月31日。结果单因素分析显示，未接受化疗的患者中，p53（+）TNBC预后差于p53（-）TNBC（P=0.003）;然而，对于接受化疗的患者，p53（+）TNBC和p53（-）TNBC之间的预后没有差异。在校正年龄和分期的多因素分析中，未化疗组中p53（+）TNBC的风险是p53（-）TNBC的1.84倍。然而，在接受化疗的患者中，p53（+）TNBC和p53（-）TNBC之间没有差异。在p53（+）TNBC中，给予化疗的风险比不给予化疗的风险低0.6倍。结论p53（+）TNBC的预后比p53（-）TNBC差，但化疗可显著降低生存风险。提示p53（+）TNBC较p53（-）TNBC对化疗更敏感。
PurposeTP53 mutation is the most common mutation in breast cancer, and it is considered a target marker of triple-negative breast cancer (TNBC). We investigated whether expression of p53 detected by immunochemical staining predicts the chemotherapy response of TNBC.MethodsA total of 11,393 TNBC patients who had between stage I and stage III enrolled in the Korean Breast Cancer Society Registry database from January 1, 2000 to December 31, 2015. There were 6,331 p53-positive (+) TNBC' patients and 5062 p53-negative (-) TNBC' patients.ResultsIn univariate analysis, p53(+) TNBC had a worse prognosis than p53(-) TNBC in patients not receiving chemotherapy (P=0.003). However, there was no difference in prognosis between p53(+) TNBC and p53(-) TNBC for patients receiving chemotherapy. In multivariate analysis adjusted for age and stage, the risk of p53(+) TNBC was 1.84 times higher than that of p53(-) TNBC in the non-chemotherapy group. However, there was no difference between p53(+) TNBC and p53(-) TNBC in patients receiving chemotherapy. In p53(+) TNBC, the risk was 0.6-fold lower when chemotherapy was administered than when chemotherapy was not administered. However, in p53(-) TNBC, there was no risk reduction effect by chemotherapy.ConclusionThe prognosis of p53(+) TNBC has worse than p53(-) TNBC, but the risk for survival was significantly reduced with chemotherapy. It suggests that p53(+) TNBC would be more sensitive to chemotherapy than p53(-) TNBC.