| BackgroundBreast cancer is one of the most common malignant tumor which is the threat to women’s health. The study has shown that the occurrence, development, recurrence and metastasis of the breast cancer has close relation with the state of the body’s immune function.In recent years, as one of the commonly used methods of comprehensive treatment for the breast cancer, the application of neoadjuvant chemotherapy is becoming more and more widely, which plays an important role in the process of comprehensive diagnosis and treatment of breast cancer.Neoadjuvant chemotherapy for the patients of locally advanced breast cancer can reduce tumor staging, which makes more patients got a chance for breast conserving therapy.In the process of individual chemotherapy through the sensitivity of the detection and screening of new drugs in the body, we can promote the development of new drugs and the conduct of a variety of clinical trials, which is another advantage of the new adjuvant chemotherapy.Although the statistical analysis of the related clinical data showed that the disease-free survival(DFS) and overall survival(OS) of the new adjuvant chemotherapy and postoperative adjuvant chemotherapy have no obvious differences, but these patients who achieve pathological complete response(pCR) by neoadjuvant chemotherapy, have their DFS and OS extensioned, while the other part of patients have disease progressioned and even distant metastasised.Therefore, accurate prediction of the curative effect of neoadjuvant chemotherapy before neoadjuvant chemotherapy become more and more crucial for individuals.In recent years, studies have shown that Treg cells are the body’s Immunosuppressive T cells, there are a small amount existing in normal human body which avoiding the occurrence of autoimmune diseases mainly by inhibiting excessive activity of the immune cell. It is reported that the high level of the CD4 + CD25 + FOXP3 + regulatory T cells(regulatory T cells, Treg cells) is one of the important ways for tumor patients to suppress immune function. The inhibition of Tregs cells on the body’s immune function is conducive to the growth and proliferation of tumor cells. Studies have shown that CD4 + CD25 + FOXP3+ regulatory T cells(regulatory T cells, Treg cells) can inhibit the proliferation of the CD8 T cells, it can speculate that Treg cell helps tumor cells realize the function of immune escape, infiltrating growth and proliferation.There are a lot of Treg cells in the patient’s body, it’s found that as the Treg cells increased significantly in tumor tissues, the degree of the tumor progression and the prognosis of patients were opposite.Through the observation of neoadjuvant chemotherapy’s influence to the body’s immune function and the relationship between FOXP3 + Tregs and clinical outcomes for patients with breast cancer, this study disscuss the feasibility of the scheme in which as an important symbol to Tregs factor can FOXP3 be a predict potential target for the effect of neoadjuvant chemotherapy for breast cancer. ObjectivesTo observe the effect of the neoadjuvant chemotherapy on FOXP3+Treg cells in the peripheral blood and tissue of the patients with invasive breast cancer, and explore the predictive value of the FOXP3+Tregs to the efficacy of neoadjuvant chemotherapy of breast cancer. MethodsA total of 73 patients with invasive breast cancer which were female and confirmed by pathological biopsy before treatment in the First Affiliated Hospital of ZhengZhou University, which were recruited for this retrospective analysis from January 2013 to December 2014. During three cycle of the TEC regimen as neoadjuvant chemotherapy, peripheral venous blood samples were collected on the first day before neoadjuvant chemotherapy and after the neoadjuvant chemotherapy for the 10 th day, and flow cytometry was used to test the changes of CD4 T cells and Treg cells in peripheral blood, FOXP3+Tregs in tissue were assessed by immunohistochemistry, and the relationship between the high or low expression of FOXP3+Tregs and the pathological complete response rate was analyzed. ResultsTreg cells in the peripheral blood of patients with breast cancer decreased obviously, however, CD4+ cells and CD4+ cells/Treg cells increased significantly after neoadjuvant chemotherapy, and the difference was statistically significant(P<0.05). Treg cells in the 57 cases of effective chemotherapy group patients were significantly lower than in the 16 cases of invalid group patients(P<0.05).The pCR was 17.8%, when compared the patients with low expression of FOXP3+Tregs, pathologic complete response rate is low in patients with high expression of FOXP3+Treg cells(P = 0.016). ConclusionNeoadjuvant chemotherapy can reduce the proportion of Treg cells in peripheral blood of breast cancer patients. The expression level of FOXP3 in Treg cells of breast cancer tissue can predict the curative effect of neoadjuvant chemotherapy, and will serve as a potential indicator of breast cancer treatment. |
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