Objective: To investigate the relationship between the expression levels of Plakoglobin protein in residual lesions after neoadjuvant chemotherapy (NAC) and the prognosis of breast cancer patients. Methods: Clinical and pathological data from 174 breast cancer patients who underwent surgery after receiving NAC at the Cancer Hospital of Chinese Academy of Medical Sciences from January 2009 to December 2017 were collected. The expression level of Plakoglobin in residual cancer lesions was evaluated by immunohistochemistry. The correlation between Plakoglobin expression level and clinicopathological features was analyzed. Survival analysis was performed using the Kaplan-Meier method, and Cox proportional hazard regression models were used for factor analysis. Results: Among the 174 patients, 140 had low expression of Plakoglobin, and 34 had high expression. The median disease-free survival (DFS) and overall survival (OS) in the Plakoglobin low expression group were 59.46 and 71.68 months, respectively, both of which were higher than those in the high expression group (36.58 and 47.26 months, respectively, both P<0.05). Univariate analysis showed that Plakoglobin expression, pathological N stage, lymphovascular invasion status, histological grade, Ki-67, and molecular subtypes were associated with OS (all P<0.05), while pathological N stage, histological grade, and Ki-67 were associated with DFS (all P<0.05). Multivariate analysis revealed that Plakoglobin expression (HR=2.438, 95% CI: 1.256-4.735, P=0.008) was an independent predictor for OS, and Ki-67 (HR=2.228, 95% CI: 1.316-3.773, P=0.003) was an independent predictor for DFS. Conclusion: In breast cancer patients with residual lesions after NAC, those with low Plakoglobin expression have relatively longer OS and Plakoglobin is an independent prognostic factor for OS.
目的： 探讨乳腺癌新辅助化疗后癌残留病灶中Plakoglobin蛋白表达水平与患者预后的关系。 方法： 收集2009年1月至2017年12月于中国医学科学院肿瘤医院行新辅助化疗后行手术的174例乳腺癌患者的临床病理资料，采用免疫组化方法评估癌残留病灶中Plakoglobin蛋白的表达水平，分析Plakoglobin蛋白的表达与临床病理特征之间的相关性，生存分析采用Kaplan-Meier法，影响因素分析采用Cox比例风险回归模型。 结果： 174例患者中，Plakoglobin蛋白低表达140例，Plakoglobin蛋白高表达34例。Plakoglobin低表达组患者的中位无病生存时间(DFS)和总生存时间(OS)分别为59.46和71.68个月，均高于高表达组患者(分别为36.58和47.26个月，均P<0.05)。单因素分析结果显示，Plakoglobin的表达、病理N分期、淋巴血管浸润状态、组织学分级、Ki-67和分子分型与OS有关(均P<0.05)，病理N分期、组织学分级和Ki-67与DFS有关(均P<0.05，表2)。多因素分析结果显示，Plakoglobin的表达(HR＝2.438，95% CI：1.256~4.735，P＝0.008)是OS的独立影响因素，Ki-67(HR＝2.228，95% CI：1.316~3.773，P＝0.003)是DFS的独立影响因素。 结论： 乳腺癌新辅助化疗后仍有癌残留病灶的患者中，Plakoglobin低表达患者的OS和DFS相对较长，Plakoglobin是OS的独立影响因素。.
Keywords: Breast neoplasms; Neoadjuvant chemotherapy; Plakoglobin protein; Prognosis; Residual cancer lesions.