Predictive value of P-gp,GSTπ combined with TOPO Ⅱα detection for pathological complete response to neoadjuvant chemotherapy in triple-negative breast cancer
Objective To analyze the predictive value of P-glycoprotein (P-gp),glutathione transferase(GSTπ)combined with topoisomerase Ⅱα(TOPO Ⅱα)assay for pathological complete remission (pCR) of neoadjuvant chemotherapy (NAC) in patients with triple negative breast cancer (TNBC). Meth-ods This study is a retrospective,single-center,double-blind trial. A total of 135 TNBC patients,all fe-male,were selected from the First Affiliated Hospital of Zhengzhou University from March 2020 to October 2022 and screened according to the inclusion and exclusion criteria. SP immunohistochemistry was used to de-tect P-gp,GSTπ,and TOPO Ⅱα to analyze the efficacy of NAC in TNBC patients,and single and multifacto-rial analyses were performed to analyze the relationship between the expression status of P-gp ,GSTπ,and TOPO Ⅱα and NAC pCR. ROC curves were plotted to analyze the predictive value of P-gp ,GSTπ,and TOPO Ⅱα single and combined assays on NAC pCR in TNBC patients. Results After NAC,47 cases (34.81％)achieved complete clinical response(cCR),72 cases(53.33％)achieved partial cPR,12 cases (8.90％)had SD,and 4 cases(2.96％)had PD. The total effective rate was 88.14％. With 21 cases(15.55％)achieving pCR. Following NAC,21 cases(15.55％)achieved pCR,in univariate analysis,the pCR rate was lower for positive expression of P-gp and GSTπcompared to expression,while the pCR rate of positive expres-sion of TOPO Ⅱα compared to negative expression,with statistically significant differences(P<0.05). P-gp, GSTπ,and TOPO Ⅱα expression were significantly associated with pCR[OR(95％CI)1.446(1.127～1.858), 1.640(1.304～2.063),and 1.548(1.227～1.984),respectively,(P<0.05)]. The sensitivity and specificity of com-bined detection of P-gp,GSTπ,and TOPO Ⅱα for NAC pCR were 90.73％and 86.73％,respectively,with an AUC(95％CI )of 0.813(0.743-0.908);all of which were higher than single detection of theseindicators(P<0.05). Conclusion The expression of P-gp,GSTπand TOPO Ⅱα was found to be correlated with NAC pCR in TNBC patients. Combining the above indicators for the detection of NAC pCR has a high predictive value. This is beneficial in helping clinicians develop more appropriate treatment strategies for TNBC patients.
P-glycoproteinTopoisomerase ⅡαGlutathione transferaseTriple-negative breast cancerNeoadjuvant chemotherapy
万方数据
维普
