Research Of Correlation Between Syndrome Pattern Of Traditional Chinese Medicine And Expression Of Prognostic Factors Of Breast Cancer

Objective:Breast cancer is common disease in China, many factors will affect its development and prognosis. Breast cancer stage, histological grading of breast cancer, the status of axillary lymph node metastasis , expression of Estrogen receptor(ER), expression of Progesteron receptor (PR), expression of HER-2, mutation of P53, expression of vascular endothelial growth factor (VEGF) and basic fibloblast growth factor (bFGF), expression of P-glycoprotein(P-gp) and Breast cancer resistant protein(BCRP) are not only useful criterions for evaluating the prognosis of breast cancer but also criteria to test the efficacy of breast cancer. Chinese medicinal herbs are effective in treating breast cancer, we often choose Chinese medicinal herbs depending on syndrome pattern of traditional Chinese medicine, because the correlation between syndrome pattern of traditional Chinese medicine and expression of prognostic factors of breast cancer are still unknown, We don't know whether the alleviation of syndrome pattern of traditional Chinese medicine of breast cancer mean the prognosis of breast cancer improved after treating for breast cancer with Chinese medicinal herbs. So it's very difficult to filler the valuable medicine from Chinese medicinal herbs.Chemotherapy affects syndrome pattern of traditional Chinese medicine obviously, but it's still unknown whether chemotherapy will change the correlation between syndrome pattern of traditional Chinese medicine and expression of prognostic factors of breast cancer.Now we are trying to find for the answer after researching and analysing.MethodsPart One: cases without chemotherapy1. 58 cases of breast cancer were selected and divided into 3 groups according to relevant criteria of syndrome manifestation adopted by "New Chinese herbs clinical research rudder" (liver stagnation and spleen insufficiency syndrome group, blood stasis syndrome group, kidney yin deficiency syndrome group)2. Evaluate breast cancer stage according to 2002 breast cancer staging system adopted by International Union Against Cancer(UICC).3. Patients received operations ( Modified radical mastectomy) , tumor tissue and axillary lymph nodes were got.4. The histological grading of breast cancer and status of axillary lymph metastasis have been appraised by Histological staining method . The expression of ER, PR, HER-2, P53, VEGF, bFGF, P-gp and BCRP in tumor tissues have been detected by SP immunohistochemical method.5. Correlation between syndrome pattern of traditional Chinese medicine and Histological grading of breast cancer, the status of axillary lymph node metastasis, expression of ER, PR, HER-2, P53,VEGF, bFGF, P-gp and BCRP in tumor tissues has been analyzed.Part two: cases after 3 cycles of neoadjuvant chemotherapy1. Measure the size of breast lump by B-ultrasonic examination, make tissue diagnosis by needle biopsy and detect the expression of P-gp and BCRP in tumor tissues by SP immunohistochemical method.2. Patients received 3 cycles of neoadjuvant chemotherapy.3. After neoadjuvant chemotherapy, 27 case of patients were divides into 3 groups according to relevant criteria adopted by new "Chinese herbs clinical research rudder" (liver stagnation and spleen insufficiency syndrome group, blood stasis syndrome group, kidney yin deficiency syndrome group)4. Check the size of breast lump again by B-ultrasonic examination,evaluate curative effect of chemotherapy.5. Patients received operations( Modified radical mastectomy) and tumor tissue and axillary lymph nodes were taken for checking in step 6.6. Histological staining method was used to appraise the status of axilary lymph metastasis. SP immunohistochemical method was used to detect the expression of ER, PR, HER-2, P53.VEGF, bFGF, P-gp and BCRP in tumor tissuesin 27 cases of breast cancer.7. The correlation between syndrome pattern of traditional Chinese medicine and curative effect of chemotherapy, the correlation between syndrome pattern of traditional Chinese medicine and expression of prognostic factors of breast cancer have been analyzed.Results1. Before chemotherapy, breast cancer stage, status of axilary lymph metastasis .expression of HER-2 and VEGF in liver stagnation and spleen insufficiency syndrome group are remarkably lower than those in other two groups, breast cancer stage, status of axilary lymph metastasis, expression of HER-2 and VEGF in blood stasis syndrome group are remarkably higher than those in the other two groups.2. Before chemotherapy, there are no significant differences in three groups in expression of ER, PR, HER-2, P53, VEGF, bFGF, P-gp and BCRP in breast cancer.3. After chemotherapy, expression of VEGF in blood stasis syndrome group is remarkably higher than that in the other two groups.4. Afer chemotherapy, there are no significant differences in three groups in curative effect of chemotherapy, the status of axilary lymph metastasis and expression of ER, PR, HER-2, P53, bFGF, P-gp and BCRP in tumor tissues.Cone I us i on1. Before chemotherapy, breast cancer of different syndrome pattern of traditional Chinese medicine have different prognosis. Patient of liver stagnation and spleen insufficiency syndrome have the best prognosis and Patient of blood stasis syndrome have the worst prognosis.2. Chemotherapy can change the correlation between syndrome pattern of traditional Chinese medicine and expression of prognostic factors of breast cancer.3. Whether patients received chemotherapy or not, expression of VEGF in blood stasis syndrome group are remarkably higher than that in the other two group. That means breast cancers of blood stasis syndrome have a liability to recurrence and have a bad prognosis. VEGF is hopeful to become one of the criteria to test the efficacy of breast cancer of blood stasis syndrome. Itis hopeful to find some angiogenesis inhibitors from Chinese medicinal herbs for Activation Blood and Resolving Stasis.