Dyamic Study On The Influence Of Neoadjuvant Chemotherapy On The Expression Of Drug Resistance Associated Protein In Breast Cancer

OBJECTIVE: By detecting the tumor tissue NAC(neoadjuvant chemotherapy),NAC2 cycle,and NAC4 cycle-related resistance proteins in breast cancer patients,P-glycoprotein(P-glycoprotein),MRP1(Multidrug Resistance Protein 1)and BCRP(Breast Cancer Resistance Protein)and ER(Estrogen receptors),PR(partial response),Her-2(Human epidermal growth factor receptor-2),Ki67 and other factors in the process of NAC expression and dynamic changes in the level of exploration of these protein and factor expression levels and tumor changes Whether the organization’s response to NAC is related.By monitoring the expression of related drug resistance proteins during the breast cancer NAC,we evaluated whether it had early warning potential for drug resistance.Methods : Sixty-three breast cancer patients with stage IIIB,stage IIIA and stage IIIB breast invasive ductal carcinoma were selected from the Department of Milk Anesthesiology,Second Affiliated Hospital of Nanhua University.NAC 2 cycles,NAC 4 cycles of breast cancer Tissues were all confirmed as pathological diagnosis of cancer,fixed,embedded,sliced immunohistochemistry(SP method)were used to detect the expression of ER,PR,Her-2,Ki67,Pgp,MRP1,BCRP.NAC efficacy was assessed by B-mode and vernier caliper measurement of tumor size and divided into four levels of complete remission(CR),partial remission(PR),stable disease(SD)and disease progression(PD),The changes of the expression of ER,PR,Her-2,Ki67,Pgp,MRP1 and BCRP in 4 cycles of NAC and the relationship between NAC efficacy and the expression of three kinds of drug resistance proteins,and to explore the relationship between Pgp,MRP1 and BCRP in breast cancer Early drug resistance in neoadjuvant chemotherapy.Result:(1)In 63 patients with invasive ductal carcinoma of the breast,the partial response of TAC neoadjuvant chemotherapy was 38.10% in 24 patients,38.0% in stable 39.0%,and 38.10% in short-term efficacy at 2 cycles.Complete remission in 3 cases accounted for 4.76%,partial remission in 40 cases accounted for 63.50%,stability in 17 cases accounted for 26.98%,progress in 3 cases accounted for 4.76%,the short-term efficiency of NAC 4 cycles 67.50%.(2)The change of status of ER,PR,her-2 and Ki67 was not statistically different in NAC process,p>0.05;(3)The expression level of Pgp,BCRP,MRP1 was before NAC,NAC 2 cycle Significant differences were found between NAC and 4-weeks,with pvalues <0.05.The expression levels of the three resistance proteins increased with the progress of NAC.(4)There was no significant difference in expression of Pgp,BCRP and MRP1 between different treatment groups at NAC 2 cycles.The p values were(Pgp = 0.195 for Pgp,p = 0.822 for BCRP,and p = 0.391 for MRP1);The expression of BCRP and MRP1 in NAC at 4 cycles was significantly different among different treatment groups.The p-value of BCRP was 0.001,and the p-value of MRP1 was 0.046.The expression of Pgp was not statistically different.The p-value was >0.05.(5)There was no significant difference in the expression of ER,PR,Her-2,and Ki67 in the first three NAC protein expressions.The p values were all > 0.05.Conclusion:1.The expression of P-gp,MRP1 and BCRP will be up-regulated with the prolongation of chemotherapy cycle.2.The expression of BCRP and MRP1 is related to the efficacy of neoadjuvant chemotherapy with TAC,and it is possible that BCRP and MRP1 have the effect of predicting the chemotherapy and early warning Resistance potential.