Study Of The Relevance Between FoxP3~+ Differential Expression Before And After Neoaddjuvant Chemotherapy Of Breast Cancer And Chemotherapy Sensitivity

objective: Breast cancer immune microenvironment plays an important role in development of breast cancer.This study was to evaluated the differential expression of Fox P3 Tregs before and after neoadjuvant chemotherapy in breast cancer and the relationship between breast cancer molecular typing 、clinical staging and histological grade. To explore the neoadjuvant chemotherapy effect on Tregs in the tumorimmune microenvironment,further evauated the effect of eoadjuvant chemotherapy on Tregs in immune microe-nvironment and the relationship between Tregs and the sensitivity of chemotherapy. Methods : We Collected 112 cases treated with neoadjuvant chemotherapy in breast surgery department of The affiliated hospital of luzhou medical colledge between January 2012~June 2014.To improve the relevant examination :mammography examination, breast ultrasound,CT,breast MRI,etc.Collect selected cases relatedclinical pathologicaldata, combined with physical examination andauxiliary comprehensive evaluation in patients withclinical stage.We used breast ultrasound and MRI to evaluat the before and after neoadjuvant chemotherapy curative effect.We choosed TAC(docetaxel 75 mg/m2, cyclophosp-hamide 500 mg/m2,pirarubicin 50 mg/m2,21 d as a course of treatment) as neoadjjuvant chemotherapy plan. After 2~4 chemotherapycycles, according to the tumor clinical curative effect,to be significant reduced for tumor surgery, clinical complete remission or have no progression. Comparison the hollow needle tissue before chemotherapy and the resection tumor tissue after chemotherapy, using IHC to clear histoloticaltype, grade, ER, PR, HER-2and Ki-67 status,and the differential expression of Fox P3 Tregs cells before and after neoadjuvant chemotherapy within the tumor. Analysis Fox P3 Tregs differential expression before and after neoadjuvant chemotherapy in breast cancer and the relationship between the differential expressionand breast cancer molecular classification, as well as the clinical stage and histological grade.Results:1.Collected related clinical data of 112 patients with breastcancer undergoing neoadjuvant chemotherapy, analyzed the relationship between clinical stage, histological grad e, ER, PR, HER-2 and the chemotherapy curative effect evaluation: clinical complete response(c CR) of breast cancer after neoadjuvant chemotherapy. 23.08% of patients with high histological grade in the c CR, only 5.48%of the patients with low histological grade in c CR after chemotherapy(c2=7.672, P=0.006); 17.86% of patients with ER negative appeared c CR after chemotherapy, And only 5.36% after chemotherapy appeared c CR in patients with ER positive(c2=4.264,P=0.039).2. We divided the 112 cases into two groups according to the WHO classification,73 cases was WHO II and 39 cases was WHO III. we foundedthere was no statistical significance in Fox P3 Treg cell population decline in WHO II and III level patients before and after neoadjuvant chemotherapy(P=0.922);We divided 112 cases into three groups According to the different clinical stage as IIB,IIIA, IIIB, 51 cases in stage IIB, 38 cases in stage IIIA, 22 cases in stage IIIB, we found there was statistical significance in FOXP3 Treg cell population decline in those three groups after neoadjuvant chemotherapy(P<0.01); IIIA group had the most obvious change before and after neoadjuvant chemotherapy in patients of Fox P3 Treg cells,while IIB group was less and IIIB was lesser. We divided112 cases into four molecular subtyoes:15patients were Luminal A,47 patients were Luminal B,37 patients were Her2-enriched,and 26 patients were basal-like.We found there was no statistical significancein FOXP3 Treg cell population decline in four molecular classification(P=0.75). 3.To evaluate the efficacy of neoadjuvant chemotherapy for solidtumors by means ofbreast ultrasound and MRI, we divided 112 patients into 2 groups :100 cases were neoadjuvant chemotherapy sensitive(clinical complete remission and partial remission of clinical) and 12 cases were neoadjuvant chemotherapy not sensitive(progressive and stable).First we compared the c PR and c CR patients of Foxp3 Treg cell decline before and after chemotherapy,the difference was not statistically significant(P=0.82);Then we compared the Foxp3 Treg cellsdecline in neoadjuvant chemotherapy sensitive and insensitive group, the difference was statistially significant(P=0.001). The neoadjuvant chemotherapy sensitive group had more significant changes of Foxp3 Treg. 4. Single factor and multiple factors regression analysis found that the tumor histological grading is an independentpredictor of c CR, While age, clinical stage, the infiltration of Fox P3 Treg value after chemotherapy, ER,PR and HER-2 had no significant effect on c CR. Conlusion: 1.The tumor tissue is more possibility of c CR appear after neoadjuvant chemotherapy in thosepatients who has higher histological grade and lower ER expression. 2.Different clinical stages,do have an influence in the changes of infiltration of Fox P3 Treg brfore and after neoadjuvant chemotherapy in breast cancer tissue, IIIA group had the most obvious decline of Fox P3 Treg brfore and after chemotherapy, indicating that Fox P3 Treg in stage IIIA has the highest sensitivity to chemotherapy,IIB stage and IIIB stage lesser.3. The decline of Fox P3 Treg were more significant in chemotherapy sensitive group than less sensitive groups of neoadjuvant in tumor tissue.There was no significant differences with the c PR and c CR group. 4. Single factor and multiple factors regression analysis found that the tumor histological grading is an independent predictor of c CR.