Research For The Application Of Detecting Serum Anti-p53 Antibody In The Breast Cancer Patients Treated With Neoadjuvant Chemotherapy

Breast carcinoma is the most common malignancy in Chinese women. Currently,the neoadjuvant chemotherapy (NAC) is the first choice for the treatment of the patients with locally advanced breast cancer. But, how to make a prediction in the process of NAC and then adjust the amount of drug usage is an issue. Traditional clinical and pathological methods are not suitable to make such a decision, however, the studies for tumor biomarkers are expected to solve this problem. Studies have found that detection of serum p53 antibody (p53 Abs) could fast, conveniently and low-costly reflect the tumor biological changes during the NAC treatment. Thus the study of p53 Abs has now become a hot pot in the researches of tumor biomarkers.The purpose of this study is to evaluate the predictive value of serum p53 Abs in taxane-based and anthracycline-based NAC. Besides, we had also studied the predictive value of carcino-embryonic antigen (CEA), carbohydrate antigen (CA) 15-3 and human epidermal growth factor receptor (HER)-2.Sixty-eight patients with locally advanced breast carcinoma were included. Thirty-two were treated with taxane (the taxane group) and 36 with anthracycline (the anthracycline group). The standard dosage of docetaxel was 100mg/m2 (day 1) and those of cyclophosphamide, adriamycin and 5-flurouracil were 500mg/m2 (day 1–8), 40mg/m2 (day 1) and 500 mg/m2 (day 1–8), respectively. The p53 Abs were detected by enzyme-linked immunosorbent assay (ELISA); CEA and CA15-3 were detected by Elecsys 2010 Disc System; HER-2 were detected by immunohistochemistry staining. The biomarkers p53 Abs, CEA and CA15-3 were detected in serum samples, and the immunohistochemistry staining for HER-2 was performed in tumor samples before and after NAC.At last, we found that the expression of p53 Abs was significantly reduced by taxane (P =0.006). The serum CEA and CA15-3 levels were significantly affected by both taxane (P = 0.004 and P = 0.008) and anthracycline (P = 0.002 and P =0.000) drugs. HER-2-negative status (pre-neoadjuvant) was correlated with a high objective response rate (OR) in both taxane-based and anthracycline-based chemotherapy (P = 0.022 and P = 0.025), whereas p53 Ab-negative status (pre-neoadjuvant) was correlated with high OR rate in anthracycline-based chemotherapy (P = 0.039). This study shows that the serum p53 Ab level is easily changed by taxane. CEA and CA15-3 levels are easily changed by taxane and anthracycline. The p53 Ab-negative patients may predict a high clinical OR rate in anthracycline-based NAC. HER-2-negative may predict a high OR in both taxane-based and anthracycline-based NAC.Finally, we conclude that detection of serum p53 Abs has guiding value in the NAC treatment.