Expressions Of Topoâ…¡a Protein And Multivariate Analysis Of Survival Rates For HER2 Positive Breast Carcinoma

Objective To explore the regularity of expression of TopoⅡa and the influence on prognosis in patients with HER2 positive breast carcinoma.Methods The expression topoⅡa was measured by immmunohistochemical assay in 103 cases of infiltrative type of HER2 positive breast carcinoma tissue all which have complete dates.The chi-square test were used in order to estimate the relations between TopoⅡa and Clinicopathological factors. The observed survival rates, hazard ratio, and Cox proportional hazard regressive model were used in order to estimate strength of relations between various clinical indicators, and prognoses of the patients with breast cancer.Results The positive expression rates of Topo1Ia was 38.8% in the breast carcinoma,overexpression of TopoⅡa was significantly correlated with axillary lymphonodus metastasis,clinical stage and histologic grade (P<0.05),but it was insignificantly correlated with ages,menstruatiion,tumor size, ER, PR, P53 and P16 (P >0.05).3-year and 5-year disease-free survival(DFS)rates of all patients were 85.4% and 70.2%. 3-year disease-free survival (DFS)rate of the TopoⅡa -positive is 77.4% and compares to 90.5% of the negative.5-year disease-free survival rate of the TopoⅡa– positive is 61.3% and compares to 75.8% of the negative. There was a significant difference between TopoⅡa -positive and negative among the positive of HER2 in 3-year and 5-year DFS(χ~2=3.872,P=0.049). 3-year disease-free Survival rate of the TopoⅡa-positive accepted anthracycline-based chemotherapy is 85.7 % and compares to 58.3% of that accepted non-anthracycline chemotherapy. 5-year disease-free Survival rate of the TopoⅡa-positive accepted anthracycline-based chemotherapy is 66.8% and compares to 46.7% of that accepted non-anthracycline chemotherapy.There was a significant difference between anthracycline-based and non-anthracycline chemotherapy among the positive of TopoⅡa in 3-year and 5-year DFS(χ~2=5.642,P=0.018). 3-year disease-free Survival rate of the TopoⅡa- negative accepted anthracycline-based chemotherapy is 92.5 % and compares to 83.3% of that accepted non-anthracycline chemotherapy. 5-year disease-free Survival rate of the TopoⅡa-negative accepted anthracycline-based chemotherapy is 78.7% and compares to 62.5% of that accepted non-anthracycline chemotherapy.There was no significant difference between anthracycline-based and non-anthracycline chemotherapy among the negative of TopoⅡa in 3-year and 5-year DFS (χ~2=1.590,P=0.207). One way analysis showed tumor size, No of ALN( + ) , anthracycline-based chemotherapy and clinical stage were related to disease-free survival (DFS) rates of patients with Topo1Ia positive breast carcinoma; No of ALN( + ), tumor size, clinical stage and ER were related to disease-free survival (DFS) rates of patients with Topo1Ia negative breast carcinoma. Multivariate analysis showed No of ALN(+) and anthracycline-based chemotherapy were related to disease-free survival (DFS) rates of patients with Topo1Ia positive breast carcinoma; No of ALN( + ) and ER were related to disease-free survival (DFS) rates of patients with Topo1Ia negative breast carcinoma.Conclusion①The positive expression rates of Topo1Ia was 38.8%in patients with HER2 positive breast carcinoma②Overexpression of Topo1Ia was significantly correlated with axillary lymphonodus metastasis,clinical stage and histologic grade .The expressions of Topo1Ia may be useful in predicting lower differentiation and later course.③TopoⅡa– positive is associated with poor 3-year and 5-year DFS. This finding provides strong support for our hypothesis that TopoⅡa is closely related with the proliferation of malignancy.④3-year and 5-year DFS associated with TopoⅡa positive could be improved with the anthracycline-based chemotherapy. It established that sensitivity to anthracyclines is dependent on the expression level of Topo IIa protein in target cancer cells.⑤One way analysis showed tumor size, No of ALN(+) , anthracycline-based chemotherapy and clinical stage were related to disease-free survival (DFS) rates of patients with Topo1Ia positive breast carcinoma ; Multivariate analysis showed No of ALN(+) and anthracycline-based chemotherapy were related to disease-free survival (DFS) rates of patients with Topo1Ia positive breast carcinoma.⑥No of ALN(+), tumor size, clinical stage ,ER ,PR and p53 were related to disease-free survival (DFS) rates of patients with Topo1Ia negative breast carcinoma;Multivariate analysis showed No of ALN( + ) and ER were related to disease-free survival (DFS) rates of patients with Topo1Ia negative breast carcinoma.