ABSTRACT
Objective To screen out significant differential genes for predicting the effect of neoadjuvant chemotherapy (NAC) and select the most suitable breast cancer patients for NAC. Methods A total of 60 breast cancer patients' samples before and after NAC were collected for high-throughput RNA-Seq. We selected AHNAK, CIDEA, ADIPOQ and AKAP12 as the candidate genes that related to tumor chemotherapeutic resistance. We analyzed the correlation of AHNAK, CIDEA, ADIPOQ, AKAP12 expression levels with the effect of NAC by logistic regression analysis, constructed a prediction model and demonstrated the model by the nomogram. Results AHNAK, CIDEA, ADIPOQ and AKAP12 expression were up-regulated in the residual tumor tissues of non-pCR group after NAC(P < 0.05). Compared with pCR group, non-pCR group presented higher expression levels of AHNAK, CIDEA, ADIPOQ and AKAP12 (P < 0.05). The high expression levels of AHNAK, CIDEA, ADIPOQ and AKAP12 significantly reduced the pCR rate of NAC for breast cancer (P < 0.05). Our prediction model which AHNAK, CIDEA, ADIPOQ and AKAP12 were involved in showed a good fitting effect with H1 test (χ2=6.3967, P=0.4945) and the ROC curve (AUC 0.8249, 95%CI: 0.722-0.9271). Conclusion AHNAK, CIDEA, ADIPOQ and AKAP12 may be novel marker genes for NAC effect on breast cancer. The efficacy prediction model based on this result is expected to be a new method to select the optimal patients of breast cancer for neoadjuvant chemotherapy.
ABSTRACT
Objective To study the clinical manifestation, pathological character, treatment strategies and prognostic factors of phyllodes tumor of breast .Methods We retrospectively reviewed 41 patients with breast phyllodes tumor.Results The average age was 35. Among all the patients, there were 20 benign cases, 5 borderline cases, 16 malignant cases. 19 patients received extensive local excision, 7 patients received local excision, 9 patients received simple mastectomy of breast and 6 patients were treated with modified radical operation. There were 4 patients undergoing radiotherapy after the operation. Follow-up was obtained for 35 cases, with an average of 26 months (5~101 months), one of the patients died of metastasis 3 years after the operation, two patients suffered from local recurrence.Conclusions Appropriate operation is the most important prognostic factor of breast phyllodes tumor.