The Forecast Value Of E-cadherin In Neoadjuvant Chemotherapy In Breast Cancer

Background:Neoadjuvant chemotherapy (NACT), as the standard care for patients with locally advanced breast cancer (LABC) and inflammatory breast cancer, has been consistently recognized. With the constant research of pathogenesis and advanced lesion of breast cancer, NACT has been widely applied. Clinical studies show that NACT results in tumor downsizing in the majority of patients and make surgery and breast conservation therapy (BCT) possible in patients blieved to be inoperable at the initial stage. The disease-free survival (DFS) and overall survival (OS) of patients who can get pathologic complete response (pCR) by NACT can be improved obviously. But the clinical trials also showed that about twenty five percent of patients cannot get benefits from NACT, even lose the operation timing or even lead to local advanced breast cancer. Therefore, the research about factors which can predict the effect of NACT can make patients avoid ineffective chemotherapy, and increase the overall efficiency and implement the individualized treatment better. At present, the relevant research about E-cadherin and breast cancer at home and abroad focus on the association between the expression of E-cadherin in breast cancer and clinicopathological features of breast cancer, in order to assess the prognosis of breast cancer. However, there are few reports about the expression of E-cadherin in breast cancer and the efficacy of NACT.Purpose:1.Analyze the differences between the expression of E-cadherin in breast cancer before and after NACT, to understand the impact of NACT on the expression of E-cadherin.2. Analyze the relationship between expression of E-cadherin and efficacy of NACT, to speculate whether E-cadherin can be used as a predictor of the efficacy of NACT in breast cancer.Method:Sixty breast cancer patients who were diagnosed by hollow needle aspiration received three cycles TAC (docetaxel+pirarubicin or epirubicin+cyclophosphamide) neoadjuvant chemotherapy, and then received surgery. Detect the expression of E-cadherin in specimens before and after NACT by IHC. Analyze the expression of E-cadherin in breast cancer before and after NACT with wilcoxon test, and the expression of E-cadherin and the efficacy of NACT with Chi-square test and spearman rank correlation test.Results:1. Among the sixty patients, there are fifty-eight invasive ductal carcinomas, two invasive lobular carcinomas. The expression of E-cadherin before and after chemotherapy shows a significant difference (P=0.02). And NACT can decrease the expression of E-cadherin in breast cancer. 2. Sixty patients with breast cancer received three cycles of TAC neoadjuvant chemotherapy. Seventeen patients achieved for SD, twenty-eight for PR,fifteen for CR, twelve for pCR and no one achieved for PD. The expression of E-cadherin and the efficacy of NACT were negatively correlated (r=-0.292, P=0.024).Conclusions:1.The expression of E-cadherin in breast cancer differs before and after NACT. NACT can reduce the expression of E-cadherin in breast cancer tissues.2. The intensity of E-cadherin expression in breast cancer and the efficacy of NACT were negatively correlated. The lower the expression of E-cadherin in breast cancer, the better the response to NACT. E-cadherin can be used as a predictor to assess the efficacy of NACT, and guide the application of chemotherapy to avoid the blind use of chemotherapy, and increase the efficiency of NACT.