生物标志物与乳腺癌预后关系的相关研究
发布时间：2018-11-11 08:17
【摘要】：目的： 乳腺癌是女性最常见的恶性肿瘤之一,严重威胁人类健康。研究表明MicroRNA-21(miRNA-21or miR-21)对乳腺癌预后有一定的预测价值,但目前的结论存在争议。本研究通过meta分析系统评估miR-21异常表达与乳腺癌患者预后的关系。 方法： 检索PubMed、EMBASE、Web of Science和中国知网(CNKI)数据库,根据纳入和排除标准,有关miR-21表达水平与乳腺癌预后关系的文献入选本研究。通过计算合并风险比(hazard ratios, HRs)及相应的95%置信区间(confidence interval, CI)以及评价研究间异质性等进行数据分析。所有统计分析在STATA12.0软件中完成。 结果： 来自10个研究的1,439例乳腺癌病例入选本meta分析。MiR-21表达水平升高,乳腺癌患者总生存期(HR=2.57,95%CI:1.37-4.81,P=0.003)及无病生存期/无复发生存期(HR=1.45,95%CI:1.16-1.82,P=0.001)均缩短,二者均具有统计学差异。而且,miR-21在亚洲人群中预后价值更明显(HR:5.07,95%CI:2.89--8.92,P0.001),在高加索人群中的预后作用未达到显著性差异(HR=1.44,95%CI:0.99_2.10,P=0.058).通过分析比值比,miR-21与肿瘤分期、组织学分级、激素受体状态等一系列临床病理特征关系密切。 结论： 本研究显示miR-21表达水平升高,乳腺癌患者预后不佳,尤其是亚洲人群。 目的： 探讨分子生物学标志物及乳腺癌分子分型等临床病理特征与乳腺癌新辅助化疗疗效的关系。 方法： 对86例在浙江大学医学院附属第二医院肿瘤外科就诊的乳腺癌新辅助化疗患者的临床病理资料进行回顾性分析。患者经B超引导下乳腺肿块穿刺病理确诊乳腺癌,免疫组织化学法明确穿刺标本中雌激素受体(estrogen receptor, ER)、孕激素受体(progesterone receptor,PR)、人类表皮生长因子受体2(human epidermal growth factor receptor-2, Her-2)和Ki-67的表达,并以此将患者分成Luminal A、 Luminal B、Her2过表达和三阴型。根据RECIST实体瘤疗效评价标准进行疗效评价,分析临床病理特征与新辅助化疗临床疗效及病理改变的关系。结果： 86例接受新辅助化疗乳腺癌患者的病理完全缓解率为24.42%,总反应率为69.77%。ER阴性患者的病理完全缓解率为48.3%，PR阴性为40%,与相应的阳性患者(ER阳性12.3%、PR阳性11.9%)相比,激素受体阴性患者病理完全缓解率高,二者均具有统计学差异(P值分别为0.001和0.002)。在新辅助化疗中使用曲妥珠单抗的Her2过表达型乳腺癌患者的临床总反应率为94.4%,未使用者为64.3%,二者临床疗效有统计学差异(P=0.021)。三阴型乳腺癌病理完全缓解率为46.2%,明显高于其他类型乳腺癌(P=0.046)。 结论： ER阴性、PR阴性乳腺癌对新辅助化疗更敏感。对于Her2过表达的乳腺癌在新辅助化疗中联用曲妥珠单抗获益更多。相较于其他类型乳腺癌,三阴型乳腺癌的新辅助化疗疗效更佳。
[Abstract]:Objective: breast cancer is one of the most common malignant tumors in women, which is a serious threat to human health. Studies have shown that MicroRNA-21 (miRNA-21or miR-21) can predict the prognosis of breast cancer, but the current conclusions are controversial. This study evaluated the relationship between abnormal expression of miR-21 and prognosis of breast cancer patients by meta analysis system. Methods: PubMed,EMBASE,Web of Science and (CNKI) databases were searched. According to the inclusion and exclusion criteria, the literature on the relationship between the expression of miR-21 and the prognosis of breast cancer was included in this study. The combined risk ratio (hazard ratios, HRs) and the 95% confidence interval (confidence interval, CI) were calculated and the heterogeneity was evaluated. All statistical analysis is done in STATA12.0 software. Results: 1439 cases of breast cancer from 10 studies were included in this meta analysis. The expression of MiR-21 increased and the total survival time (HR=2.57,95%CI:1.37-4.81,) of breast cancer patients increased. P0. 003) and disease-free survival / relapse-free survival (HR=1.45,95%CI:1.16-1.82,P=0.001) were shortened, and there was statistical difference between them. Moreover, miR-21 had more significant prognostic value (HR:5.07,95%CI:2.89--8.92,P0.001) in Asian population than in Caucasian population (HR=1.44,95%CI:0.99_2.10,). P0. 058) By analyzing the ratio, miR-21 is closely related to a series of clinicopathological features such as tumor stage, histological grade, hormone receptor status, etc. Conclusion: this study showed that the expression of miR-21 increased and the prognosis of breast cancer patients was poor, especially in Asian population. Objective: to investigate the relationship between molecular biomarkers, molecular classification and neoadjuvant chemotherapy in breast cancer. Methods: the clinicopathological data of 86 patients with neoadjuvant chemotherapy of breast cancer in the second affiliated Hospital of Zhejiang University Medical College were retrospectively analyzed. Breast cancer was diagnosed by puncture and pathology under the guidance of B-ultrasound. The estrogen receptor (estrogen receptor, ER), progesterone receptor (progesterone receptor,PR) was determined by immunohistochemical method. The expression of human epidermal growth factor receptor 2 (human epidermal growth factor receptor-2, Her-2) and Ki-67 were divided into Luminal A, Luminal Bu Her2 overexpression and triple negative type. The clinical and pathological characteristics of neoadjuvant chemotherapy were analyzed according to the evaluation criteria of RECIST solid tumor. Results: the pathological complete remission rate of 86 breast cancer patients receiving neoadjuvant chemotherapy was 24.42 and the total response rate was 48.3 PR negative in 69.77%.ER negative patients. Compared with the corresponding positive patients (ER positive 12.3% and PR positive 11.9%), the complete remission rate of steroid receptor negative patients was higher than that of the corresponding positive patients (P = 0.001 and 0.002, respectively). In neoadjuvant chemotherapy, the total clinical response rate of Her2 overexpression breast cancer patients treated with tritozumab was 94. 4% and 64.3% respectively. There was statistical difference between the two groups (P0. 021). The pathological complete remission rate of triple negative breast cancer was 46.2, which was significantly higher than that of other types of breast cancer (P0. 046). Conclusion: ER negative and PR negative breast cancer are more sensitive to neoadjuvant chemotherapy. For breast cancer with Her2 overexpression, combined use of trotozumab was more beneficial in neoadjuvant chemotherapy. Neoadjuvant chemotherapy is better for triple negative breast cancer than for other types of breast cancer.
【学位授予单位】：浙江大学
【学位级别】：博士
【学位授予年份】：2015
【分类号】：R737.9
本文编号：2324291
[Abstract]:Objective: breast cancer is one of the most common malignant tumors in women, which is a serious threat to human health. Studies have shown that MicroRNA-21 (miRNA-21or miR-21) can predict the prognosis of breast cancer, but the current conclusions are controversial. This study evaluated the relationship between abnormal expression of miR-21 and prognosis of breast cancer patients by meta analysis system. Methods: PubMed,EMBASE,Web of Science and (CNKI) databases were searched. According to the inclusion and exclusion criteria, the literature on the relationship between the expression of miR-21 and the prognosis of breast cancer was included in this study. The combined risk ratio (hazard ratios, HRs) and the 95% confidence interval (confidence interval, CI) were calculated and the heterogeneity was evaluated. All statistical analysis is done in STATA12.0 software. Results: 1439 cases of breast cancer from 10 studies were included in this meta analysis. The expression of MiR-21 increased and the total survival time (HR=2.57,95%CI:1.37-4.81,) of breast cancer patients increased. P0. 003) and disease-free survival / relapse-free survival (HR=1.45,95%CI:1.16-1.82,P=0.001) were shortened, and there was statistical difference between them. Moreover, miR-21 had more significant prognostic value (HR:5.07,95%CI:2.89--8.92,P0.001) in Asian population than in Caucasian population (HR=1.44,95%CI:0.99_2.10,). P0. 058) By analyzing the ratio, miR-21 is closely related to a series of clinicopathological features such as tumor stage, histological grade, hormone receptor status, etc. Conclusion: this study showed that the expression of miR-21 increased and the prognosis of breast cancer patients was poor, especially in Asian population. Objective: to investigate the relationship between molecular biomarkers, molecular classification and neoadjuvant chemotherapy in breast cancer. Methods: the clinicopathological data of 86 patients with neoadjuvant chemotherapy of breast cancer in the second affiliated Hospital of Zhejiang University Medical College were retrospectively analyzed. Breast cancer was diagnosed by puncture and pathology under the guidance of B-ultrasound. The estrogen receptor (estrogen receptor, ER), progesterone receptor (progesterone receptor,PR) was determined by immunohistochemical method. The expression of human epidermal growth factor receptor 2 (human epidermal growth factor receptor-2, Her-2) and Ki-67 were divided into Luminal A, Luminal Bu Her2 overexpression and triple negative type. The clinical and pathological characteristics of neoadjuvant chemotherapy were analyzed according to the evaluation criteria of RECIST solid tumor. Results: the pathological complete remission rate of 86 breast cancer patients receiving neoadjuvant chemotherapy was 24.42 and the total response rate was 48.3 PR negative in 69.77%.ER negative patients. Compared with the corresponding positive patients (ER positive 12.3% and PR positive 11.9%), the complete remission rate of steroid receptor negative patients was higher than that of the corresponding positive patients (P = 0.001 and 0.002, respectively). In neoadjuvant chemotherapy, the total clinical response rate of Her2 overexpression breast cancer patients treated with tritozumab was 94. 4% and 64.3% respectively. There was statistical difference between the two groups (P0. 021). The pathological complete remission rate of triple negative breast cancer was 46.2, which was significantly higher than that of other types of breast cancer (P0. 046). Conclusion: ER negative and PR negative breast cancer are more sensitive to neoadjuvant chemotherapy. For breast cancer with Her2 overexpression, combined use of trotozumab was more beneficial in neoadjuvant chemotherapy. Neoadjuvant chemotherapy is better for triple negative breast cancer than for other types of breast cancer.
【学位授予单位】：浙江大学
【学位级别】：博士
【学位授予年份】：2015
【分类号】：R737.9
【参考文献】
相关期刊论文 前1条
1 颜黎栩;黄马燕;吴秋良;邵建永;;miR-21表达异常与乳腺癌临床病理特征及预后的关系[J];中国病理生理杂志;2009年04期
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