The Value Of S100A4in The Evaluation Of The Neoadjuvant Chemotherapy In Breast Cancer

BackgroundBreast cancer is one of the most common malignant tumor in women, According tothe data, The incidence of Breast cancer is about7%-10%of the total malignant tumors,which is more common in women before and after menopause onset. More than acentury ago, Halsted put forward the radical mastectomy for breast cancer, from then on,The treatment of breast cancer experienced resection from simple operation to compre-hensive treatment, especially, the neoadjuvant chemotherapy(NACT) is becoming moreand more important, which has become the Standard treatment of inflammatory breastcancer and locally advanced breast cancer. With the indepth study of breast cancer path-ogenesis and disease progression, the application of neoadjuvant chemotherapy is moreand more widely. Clinical research data shows that, the neoadjuvant chemotherapy can notonly increase the chance of operation for the advanced breast cancer, but also can enhancethe rate of breast conserving surgery. further more, it can significantly improve the patie-nts with neoadjuvant chemotherapy patients’ overall survival (OS) and disease-free survi-veal(DFS),who have get the pathological complete response(pCR). However, accordingto reports, About1/5-1/4of patients failed to benefit from neoadjuvant chemotherapy andContributing to disease progression, and even lead to lose the chance of operation. So, Theevaluation of the neoadjuvant chemotherapy in breast cancer is becoming more and moreimportant. To explore the curative effect of neoadjuvant chemotherapy predictors, whichcan not only avoid insensitivity to Chemotherapy to patients with pain, but also can savethe economy consumption, and this is a good way to improve the efficient neoadjuvantchemotherapy, further more, it can guide the choice of individualized chemotherapyregimens. At present Research at home and abroad about S100A4，in breast cancer，mainly involving the correlation about S100A4expression in breast cancer and its invasion,metastasis and prognosis. However, The relatinship between the expression of S100A4andThe evaluation of the neoadjuvant chemotherapy is very poor. Purpose1. Analyze the differences between the expression of S100A4in breast cancer before2cycles of NACT and after4cycles of NACT, to explore the impact of NACT on the exp-ression of S100A4.2. Exploration the relationship between expression of S100A4and efficacy of NACT,to preliminary inference that if S100A4can be used as a predictor of the efficacy of NAC-T in breast cancer.MethodIn experiment,sixty-five patients who were newly diagnosed by high frequency colorDoppler-guided core needle biopsy with invasive breast cancer (IIA,IIB,IIIA) patients,received two cycles TEC (docetaxel75mg/m2+epirubicin75mg/m2+cyclophosphamide500mg/m2) neoadjuvant chemotherapy, And then accept the high frequency color Doppler-guided core needle biopsy again, and after four cycles TEC neoadjuvant chemotherapyreceived surgery. Detect the expression of S100A4in Samples among before NACT/aftertwo cycles NACT and after four cycles NACT by IHC. And evaluate the effect of NACT inCNB Samples between after two cycles NACT and after four cycles NACT by Miller andPayne (M&P) for pathological grading system. The data were analyzed using SPSS17statistical soft-ware, To explore the changes of S100A4expression among before NACT、after two cycles NACT and after four cycles NACT, and its correlation with the evaluationof neoadjuvant chemotherapy.Results1.Among the sixty-five patients, there are four invasive lobular carcinomas, sixty-oneinvasive ductal carcinomas. The expression of S100A4between before NACT and afterfour cycles NACT by IHC shows a significant difference(P＜0.05). The expression ofS100A4between before NACT and after two cycles NACT by IHC shows no differ-rence(P＞0.05).2. Among the sixty-five patients, after two cycles NACT, there are SD18cases, PR39cases, CR8cases; Miller and Payne (M&P) for pathological grading system:9cases ofgrade I,13cases of grade II,37cases of grade III,6cases of grade IV. after four cyclesNACT, there are SD16cases, PR31cases, CR18cases, no PD case; Miller and Payne(M&P) for pathological grading system:7cases of grade I,12cases of grade II,19casesof grade III,13cases of grade IV,13cases of grde V. The intensity of S100A4expressionand the efficacy of NACT were positively correlated(r=0.259，P＜0.05).3. Analyze the differences between after two cycles NACT and after four cycles NACT by M&P system shows that after two cycles NACT less than grade III, if weregiven two cycles NACT again could not achieve the expected effect of neoadjuvantchemotherapy.Conclusions1. The expression of S100A4between before NACT and after four cycles NACT byIHC shows a significant difference，and the expression of S100A4was reduced duringthe NACT. The expression of S100A4between before NACT and after two cycles NACTby IHC shows no difference.2. The intensity of S100A4expression and the efficacy of NACT were positivelycorrelated，The higher the expression of S100A4, the better the response to NACT.We canconsider the S100A4as a predictor to evaluate the efficacy of NACT. Guide to choose theindividual therapeutic regimen. In order to improve the effectiveness of neoadjuvant che-motherapy.3. Analyze the differences between after two cycles NACT and after four cyclesNACT by M&P system shows: After two cycles NACT less than grade III, should considerto replace chemotherapy regimens, in order to reduce patients’ economic and physical andmental damage, and can improve the effectiveness of neoadjuvant chemotherapy as well.