| Objective: In recent years, as a rising of incidence rate, breast cancer hadbecome the most important malignant tumors treated to women's health. Ithad become the most successful and effective treatment for hormonereceptor-positive breast cancer to assist endocrine therapy with representativeof tamoxifen. So in these years, the studis have foucs on the resistance oftamoxifen. Research have shown that PAX2(Paired box gene2) andAIB-1(Amplified in breast cancer-1) regulates the transcription level ofhuman epidermal growth factor receptor-2(ERBB2/Her-2) during thetreatment to estrogen receptor(ER)-postive breast cancer with tamoxifen.Further PAX2and AIB-1regulated the expression of HER-2protein, andinflunced the tamoxifen therapy of ER-positive breast cancer patients. In thisstudy, we detected the expression of PAX2and AIB-1protien of88ER-positive patients treated with tamoxifen (TAM) after modified radicalmastectomy with streptavidin peroxdase (S-P) conjugated method.Analysed the relationship between the expression levels anti-estrogentherapy resistance, and promted new indicators for the reasonable choice andvalidity determination of Endocrine therapy of breast cancer.Methods: Collected88tumor tissue samples of ER-positive patientstreated with tamoxifen (TAM) after modified radical mastectomy.According to follow-up results within5years:50cases of patients were freesurvival (TAM sensitive), and38cases of patients appeared local recurrenceor distant metastasis (TAM-resistance). Detected the expression of PAX2andAIB-1protein of breast cancer tissues, analysed the quantitative relationshipbetween these two protein, and the correlation between the expression level ofPAX2, AIB-1and TAM treatment. In addition, contrast the difference between different groups according to a variety of factors, including age, menstrualstatus, clinical stage, diameter of the tumors, histology grade, state of themetastatic axillary lymph nodes, pathology type and the expression of ER, PR,HER-2on protein level.All statistical analyses were performed with Chi-square test of SPSS13.0software. α=0.05was the size of the test．Result:1. Follow-up results:Among88cases of breast cancer patients, there were50cases appearedtumor-free survival, while38cases appeared local recurrence or distantmetastasis within5years after surgery, with the mean disease-freesurvival(DFS) of20month and the mean overall survival(OS) of32month.2. The relationship between the expression of PAX2protein and Clinical andpathological features.88cases of breast cancer patients were divided into two groups accordingto the age(<50years and≥50years), the over-expression of PAX2proteinbetween them had no significant difference (χ~2=1.349, p=0.246)． Consideredthat the expression density of PAX2protein had no significant correlationbetween the age of the patients.88cases of breast cancer patients were divided into two groups accordingto the menstrual status (premenopause and postmenopause), theover-expression of PAX2protein between them had no significant difference(χ~2=0.134, p=0.714)． Considered that the expression density of PAX2proteinhad no significant correlation between the menstrual status of the patients.88cases of breast cancer patients were divided into two groups accordingto the diameter of the tumors (≤5cm and>5cm), the over-expression of PAX2protein between them had significant difference (χ~2=4.244,p=0.039)． Considered that the expression rate of PAX2protein was lower inthe group of T>5cm.88cases of breast cancer patients were divided into two groups accordingto the clinical stage (stage I~II and III), the over-expression of PAX2protein between them had no significant difference (χ~2=0.243, p=0.622)． Consideredthat the expression density of PAX2protein had no significant correlationbetween the clinical stage of the patients.88cases of breast cancer patients were divided into two groups accordingto the histological grade (grade I~II and III), the over-expression of PAX2protein between them had no significant difference (χ~2=0.085,p=0.771)． Considered that the expression density of PAX2protein had nosignificant correlation between the histological grade of the patients.88cases of breast cancer patients were divided into two groups accordingto the state of the axillary lymph nodes (negative and positive), theover-expression of PAX2protein between them had no significant difference(χ~2=0.477, p=0.490). And we divided them into three groups according to thestate of the axillary lymph nodes (negative,1~3, and＞3), theover-expression of PAX2protein among them had no significant difference(χ~2=1.517, p=0.468)． Considered that the expression density of PAX2proteinhad no significant correlation between the state of the axillary lymph nodes ofthe patients.88cases of breast cancer patients were divided into three groups accordingto the state of the pathological types (invasive ductal carcinoma, invasivelobular carcinoma and other), the over-expression of PAX2protein amongthem had no significant difference (χ~2=3.158, p=0.206)． Considered that theexpression density of PAX2protein had no significant correlation between thepathological types of the patients.88cases of breast cancer patients were divided into two groups accordingto the expression level of HER-2(low-expression and over-expression), theover-expression of PAX2protein between them had significant difference(χ~2=5.301, p=0.021)． Considered that the expression level of PAX2protein islower in the group of over-expression of HER-2protien.88cases of breast cancer patients were divided into two groups accordingto the expression level of ER (+),(++) and (+++), the over-expression ofPAX2protein between them had no significant difference (χ~2=1.130, p=0.568)． Considered that the expression density of PAX2protein had nosignificant correlation between the expression level of ER.88cases of breast cancer patients were divided into two groups accordingto the expression level of PR (negative and positive), the over-expression ofPAX2protein between them had no significant difference (χ~2=0.488,p=0.485)． Considered that the expression density of PAX2protein had nosignificant correlation between the expression level of PR.3. The relationship between the expression of AIB-1protein and Clinical andpathological features.88cases of breast cancer patients were divided into two groups accordingto the age(<50years and≥50years), the over-expression of AIB-1proteinbetween them had no significant difference (χ~2=0.549, p=0.459)． Consideredthat the expression density of AIB-1protein had no significant correlationbetween the age of the patients.88cases of breast cancer patients were divided into two groups accordingto the menstrual status (premenopause and postmenopause), theover-expression of AIB-1protein between them had no significant difference(χ~2=0.074, p=0.785)． Considered that the expression density of AIB-1proteinhad no significant correlation between the menstrual status of the patients.88cases of breast cancer patients were divided into two groups accordingto the diameter of the tumors (≤5cm and>5cm), the over-expression of AIB-1protein between them had no significant difference (χ~2=0.433,p=0.511)． Considered that the expression density of AIB-1protein had nosignificant correlation between the diameter of the tumors of the patients..88cases of breast cancer patients were divided into two groups accordingto the clinical stage (stage I~II and III), the over-expression of AIB-1proteinbetween them had no significant difference (χ~2=7.140, p=0.008)． Consideredthat the expression level of AIB-1protein is higher in the group of the clinicalstage III.88cases of breast cancer patients were divided into two groups accordingto the histological grade (grade I~II and III), the over-expression of AIB-1 protein between them had no significant difference (χ~2=0.155,p=0.694)． Considered that the expression density of AIB-1protein had nosignificant correlation between the histological grade of the patients.88cases of breast cancer patients were divided into two groups accordingto the state of the axillary lymph nodes(negative and positive), theover-expression of AIB-1protein among them had no significant difference(χ~2=2.370, p=0.124). And we divided them into three groups according to thestate of the axillary lymph nodes(negative,1~3,and>3), the over-expressionof AIB-1protein among them had no significant difference (χ~2=2.399,p=0.301)． Considered that the expression density of AIB-1protein had nosignificant correlation between the state of the axillary lymph nodes of thepatients.88cases of breast cancer patients were divided into three groups accordingto the state of the pathological types (invasive ductal carcinoma, invasivelobular carcinoma and other), the over-expression of AIB-1protein amongthem had no significant difference (χ~2=2.214, p=0.331)． Considered that theexpression density of AIB-1protein had no significant correlation between thepathological types of the patients.88cases of breast cancer patients were divided into two groups accordingto the expression level of HER-2(low-expression and over-expression), theover-expression of AIB-1protein between them had significant difference(χ~2=7.912, p=0.005)． Considered that the expression level of AIB-1protein islower in the group of over-expression of HER-2protein.88cases of breast cancer patients were divided into two groups accordingto the expression level of ER (+),(++)and(+++), the over-expression of AIB-1protein between them had no significant difference (χ~2=2.247,p=0.325)． Considered that the expression density of AIB-1protein had nosignificant correlation between the expression level of ER protein.88cases of breast cancer patients were divided into two groups accordingto the expression level of PR (negative and positive), the over-expression ofAIB-1protein between them had no significant difference (χ~2=3.930, p=0.047)． Considered that the expression level of AIB-1protein is higher inthe group of PR protein positive.4. Relationship between PAX2protein, AIB-1protein and recurrence ormetastasis of breast cancer.Among88cases of breast cancer,38cases appeared recurrence ormetastasis, while50cases were free survival within5years. After statisticalanalysis, recurrence or metastasis rate of breast cancer patients had nosignificant difference between different groups of expression of AIB-1protein(χ~2=0.252, p=0.616), while had significant difference between differentgroups of PAX2protein(χ~2=4.219, p=0.040). Considered that AIB-1proteinwas not sensitive for prognosis of TAM treatment, while recurrence ormetastasis rate of breast cancer patients was lower in the group ofover-expression of PAX2protein.Conclusion:Among88cases of the ER-positive breast cancer patients treated withtamoxifen (TAM):1. The expression of PAX2in the breast cancer tissues had no significantcorrelation with age, menstrual status, clinical stage, histology grade, state ofthe metastatic axillary lymph nodes, pathology type and the expression of ER,PR on protein level. The PAX2protein had lower over-expression rate in bothgroup of T>5cm and over-expression of HER-2protein.2. The expression of AIB-1in the breast cancer tissues had no significantcorrelation with age, menstrual status, diameter of the tumors, histology grade,state of the metastatic axillary lymph nodes, pathology type and the expressionof ER protein. The AIB-1protein had higher over-expression rate in bothgroup of clinical stage-III and over-expression of HER-2and PR protein.3. The5years recurrence or metastasis rate had no significant correlationAIB-1protein, while the5years recurrence or metastasis rate was lower in thegroup of over-expression of PAX2protein. |
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