The Correlation Between BCRP And Efficacy Of Neoadjuvant Chemotherapy And Pathological Parameters

Objective: The expression of BCRP was investigated in breastcarcinoma tissue before neoadjuvant chemotherapy in this research. Analyzedthe correlation between the expression of BCRP and efficacy of neoadjuvantchemotherapy and ER, PR, HER-2, P53, Ki-67, and explored the value ofBCRP for the prediction of efficacy of neoadjuvant chemotherapy for guidingthe further selection of drugs for neoadjuvant chemotherapy andindividualized treatment.Methods: This study recruited84patients of stageⅡ-Ⅲ with primarybreast cancer from July2010to December2011at Breast Center of4thhospital of Hebei Medical University. The expression of BCRP in breastcarcinoma tissue got by core needle biopsy was investigated by MaxVisionTMone step before chemotherapy. Then compared with ER, PR, HER-2, P53,Ki-67and pathological changes of post chemotherapy surgical specimens,analyzed the correlation bewteen the expression of BCRP and efficacy ofneoadjuvant chemotherapyand the clinical pathological parameters.Results:1,The positive expression rate of BCRP was71.43%in patients withprimary breast cancer.2,The expression of BCRP was associated with the clinical efficacy ofneoadjuvant chemotherapy.The average rank of the expression of BCRP inpatients with acquired cCR after neoadjuvant chemotherapy was29.41,significantly lower than48.10in group of SD+PD. Also it was lower than46.50in group of cPR. The expression of BCRP between the three groupswere significant difference, χ~2=9.779, P=0.008.Compared the group of cCR tocPR,they were significant difference. χ~2=8.130,P=0.004.3, The expression of BCRP was accociated with the pathological response after neoadjuvant chemotherapy, it was significantly lower in groupof major histological response(MHR) than that in group of non majorhistological response(NMHR), χ~2=8.649, P=0.003. Compared the expressionof BCRP between the group of pCR and non-pCR in MHR,it was lower in thegroup of pCR, χ~2=7.202,P=0.007.4,There was significant relevance between the expression of BCRP andthe number of axillary lymph node metastases. r=0.518, P=0.000.5,The total response rate of neoadjuvant chemotherapy was70.24%, atotal of22of patients acquired clinical response (cCR), and37patientsacquired partial response (cPR),9patients acquired pathological completeresponse (pCR). Different neoadjuvant chemotherapy regimens were notassociated with the clinical efficacy.The regimen based on anthracyclinecompared to anthracycline plus taxane, the rate of OR was respectively66.67%,71.93%, χ~2=0.243P=0.402; the rate of OR was respectively10.71%,10.53%, χ~2=0.007P=0.935, there was no significant difference.6, The clinical efficacy of neoadjuvant chemotherapy in differentmolecular subtype of breast cancer was different. In Luminal and HER-2+andBasal-like groups, the rate of OR was58.62%,86.67%,64.00%, respectivily.The rate of OR was higher in HER-2+. In Luminal and HER-2+and Basal-likegroups, the rate of pCR was0.00%,16.67%,16.00%, respectivily. In HER-2+and Basal-like groups, the rate of pCR was higher than that in Luminal group.7,The expression of BCRP was not accociated with age, menstruationand clinical stage.8,The expression of BCRP was not accociated with the expression of ER,PR, HER-2, P53and Ki-67.Conclusion:1,BCRP is expressed in breast carcinoma tissue.2, The expression of BCRP can predict the clinical efficacy ofneoadjuvant chemotherapy.3,The expression of BCRP is significantly lower in group of majorhistological response than the group of non major histological response. 4,There is significant relevance between the expression of BCRP and thenumber of axillary lymph node metastases, the expression of BCRP canpredict the prognosis after neoadjuvant chemotherapy.5, There is no significant difference between anthracycline andanthracycline plus taxane in the treatment of breast cancer in this research.6,Molecular subtype can predict the efficacy of breast cancer patientstreated with neoadjuvant chemotherapy．Compared with Luminal subtype,patients of HER-2+and Basal-like subtype have increased pCR rate in thisresearch.7,The expression of BCRP is not accociated with the expression of ER,PR, HER-2, P53and Ki-67in this research.