The Relationship Between P53Gene Mutation And Breast Cancer Neoadjuvant Chemotherapy Efficiency

ObjectiveTumor suppressor gene p53has been implicated in growth and apoptosis of breast tumor cells and resistance to chemotherapy. This study was performed to further access the differences between Immunohis-tochemistry(IHC), the most common way to detect p53gene mutation in clinical research, and polymerase chain reaction-single strand conformation polymorphism (PCR-SSCP) analysis in the inspection of p53mutation in breast cancer patients. In addition, we tried to figure out the relationship between the mutation and some clinical histologic indexes. Then, we had conducted the study of the prognostic value of p53mutation to chemotherapy response of anthracycline and taxanes, in order to evaluate the significance of the gene mutation for short term outcomes.MethodSixty-five patients with phase â…¡A, â…¡B and â…¢A breast cancer received neoadjuvant chemotherapy treatment of EC or TC or TAC scheme for three cycles. IHC and plasma PCR-SSCP were used to detect the mutation of p53gene while ultrasound was used to evaluate the effectiveness of neoadjuvant chemotherapy.Result1. Mutation of p53gene was directly relative to IIIA stage of TNM classification, metastasis of axillary nodes and negative of ER expression (p=0.047,0.032, and0.036), rather than age, menstrual condition, tumor histological grade, and expression of PgR, C-erbB2and Ki67.2. Among molecular subclasses of breast cancer, p53gene mutation was more common in thiple-negative subtype (9%) while non-mutation in luminal B subtype (34%).3. The result of PCR-SSCP was familiar with IHC in detecting p53gene mutation, and the similarity was high.4. None of the tumors with p53mutation were response to EC, TC or TAC scheme. In the contract, tumors without p53mutation showed a good response to TAC scheme (p=0.025).5. A significant correlation with neoadjuvant chemotherapy efficiency and axillary node metastasis, expression of ER, C-erbB2and p53mutation was found. Meantime, age, menstrual condition, TNM classification, and expression of PgR and Ki67were not correlation with the response to treatment (p<0.05). And ER and p53were regarded as protective factors of breast cancer (b<0).Conclusion1. Mutation of p53gene was directly relative to IIIA stage of TNM classification, metastasis of axillary nodes and negative of ER expression. Also, p53gene mutation was more common in thiple-negative subtype breast cancer, while non-mutation was in luminal B subtype.2. None of the tumors with p53mutation were response to EC or TC or TAC scheme. In the contract, tumors without p53mutation showed a good response to TAC scheme, which might provide a guide for future clinical therapy.3. PCR-SSCP analysis was just as the effective as IHC in detecting p53gene mutation.