Relationship between P-glycoprotein function in peripheral blood cells and multidrug resistance in breast carcinoma / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To analyze the relationship between P-glycoprotein function in peripheral blood cells and primary multidrug resistance in breast carcinoma.</p><p><b>METHODS</b>P-gp function was investigated by flow cytometry in NK cells of 16 breast cancer patients treated with anthracyclines and taxanes. Among all the patients, 8 were in chemotherapy-sensitive group and 8 in chemotherapy-resistant group. P-gp function was determined by rhodamine 123 (Rh123)-ejection test. Mathematical model was established by a regression of the fluorescence-time curve. The efflux rate constants of the chemotherapy-sensitive and -resistant groups were compared.</p><p><b>RESULTS</b>There was no significant difference of Rh123 accumulation, retention or efflux between the two groups. The mathematical model of F(t) = F(0) · e(-kt) was established. K was the efflux rate constant, which was significantly different between the chemotherapy-sensitive and -resistant groups (P = 0.025). When k > 3.9 was used as diagnostic criterium for primary resistance, the sensitivity, specificity and accuracy were 75.0%, 100% and 87.5%, respectively.</p><p><b>CONCLUSION</b>P-glycoprotein function in peripheral blood cells is associated with primary multidrug resistance in breast carcinoma. The efflux rate constant may be a good predictor for chemotherapy sensitivity.</p>

Clinical features and prognostic factors of small breast cancer with multiple axillary lymph node metastasis / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To analyse the clinical features and prognostic factors of small breast cancer patient (T < or =2 cm) with multiple axillary lymph node metastasis (N > or =4).</p><p><b>METHODS</b>The data of 118 small breast cancer patients (T < or =2 cm) with multiple axillary lymph node metastasis (N > or =4) surgically treated from 1993 to 2003 were retrospectively analysed by SPSS 13.0 software.</p><p><b>RESULTS</b>The overall 5-year survival rate was 75.0% in this series. It was found by single-variant Kaplan-Merier analysis that the stage, adjuvant chemotherapy and adjuvant endocrine therapy significantly influenced the outcome of the patients. For patients with 4-9 or > or =10 metastatic axillary lymph nodes, the 5-year OS was 89.5% and 59.8%, respectively (P = 0.009). It was 82.1% and 53.3% in the patients with or without adjuvant chemotherapy (P = 0.001), respectively. For patients with or without adjuvant endocrine therapy, the 5-year OS was 89.2% and 61.9% (P = 0.001). Multi-variant Cox regression analysis showed that the stage, adjuvant chemotherapy and adjuvant endocrine therapy were independent prognostic factors.</p><p><b>CONCLUSION</b>Small breast cancer with multiple axillary lymph node metastasis usually has a tendency of metastasis with a poor prognosis, especially in those with > or =10 metastatic axillary lymph nodes. The stage, adjuvant chemotherapy and adjuvant endocrinetherapy were independent prognostic factors. Reasonable multi-modality therapy may be able to improve the outcome of these patients.</p>