2021 年第 12 期 第 16 卷

新辅助化疗前后乳腺癌患者肿瘤组织中白细胞分化抗原47表达与临床病理特征及预后的关系

Relationship of cluster of differentiation 47 expression before and after neoadjuvant chemotherapy, clinicopathological features and prognosis in tumor tissues of patients with breast cancer

作者：贺晨宇1朱明智1谷元廷1李文才2高冬玲2黄会粉2任华艳2

英文作者：He Chenyu1 Zhu Mingzhi1 Gu Yuanting1 Li Wencai2 Gao Dongling2 Huang Huifen2 Ren Huayan2

单位：1郑州大学第一附属医院乳腺外二科450000；2郑州大学第一附属医院病理科450000

英文单位：1The Second Department of Breast Surgery the First Affiliated Hospital of Zhengzhou University Zhengzhou 450000 China; 2Department of Pathology the First Affiliated Hospital of Zhengzhou University Zhengzhou 450000 China

关键词：乳腺癌；白细胞分化抗原47；新辅助化疗；肿瘤免疫微环境；预后

英文关键词：Breastcancer;Clusterofdifferentiation47;Neoadjuvantchemotherapy;Tumorimmunemicroenvironment;Prognosis

• 摘要：

• 目的 探讨新辅助化疗（NAC）前后乳腺癌患者肿瘤组织中白细胞分化抗原47（CD47）表达与临床病理特征及预后的关系。方法 回顾性分析2016年5月至2017年7月郑州大学第一附属医院收治的61例乳腺浸润性癌患者的临床病理资料及预后信息。所有患者接受NAC后行乳腺癌根治术。采用免疫组织化学法检测患者NAC前及NAC后乳腺癌根治术后肿瘤组织中CD47的表达，采用Kaplan-Meier生存曲线分析CD47表达情况与患者生存预后的关系。结果  61例患者中，NAC前肿瘤组织中CD47阳性30例、阴性31例，共14例术后为病理性完全缓解，未再测定CD47表达，其余47例术后CD47阳性率明显低于NAC前［17.0%（8/47）比51.1%（24/47）］（P＜0.001）。NAC前CD47阳性患者年龄＜50岁、组织学分级3级比例均高于CD47阴性患者［70.0%（21/30）比38.7%（12/31）、46.7%（14/30）比19.4%（6/31）］（均P＜0.05），其他临床病理学特征比较差异均无统计学意义（均P＞0.05）。Kaplan-Meier生存曲线分析结果显示，NAC前及NAC后乳腺癌根治术后CD47阳性患者总生存期、无病生存期均长于CD47阴性患者，但差异均无统计学意义（均P＞0.05）。结论  NAC能够改变乳腺浸润性癌组织中CD47的表达情况，接受NAC前患者年龄＜50岁、高组织学分级更易表达CD47，但NAC前后CD47表达无法预测患者预后。

• Objective To explore the relationship of expression of cluster of differentiation 47 (CD47) expression before and after neoadjuvant chemotherapy (NAC), clinicopathological features and prognosis in tumor tissues of patients with breast cancer. Methods Clinicopathological data and prognostic information of 61 patients with invasive breast cancer admitted to the First Affiliated Hospital of Zhengzhou University from May 2016 to July 2017 were retrospectively analyzed. All patients were treated with NAC, and then underwent radical mastectomy. Immunohistochemistry method was used to detect CD47 expression in tumor tissues before NAC and after radical mastectomy based on NAC. Kaplan-Meier survival curve was used to analyze the relationship between CD47 expression and survival prognosis in patients. Results Among 61 patients, there were 30 patients with CD47 positive and 31 patients with CD47 negative in tumor tissues before NAC. Fourteen patients had pathological compete response after operation and CD47 expression was not detected for them again. In the remaining 47 patients, the CD47 positive rate after operation was lower than that before NAC［17.0%（8/47） vs 51.1%（24/47）］（P＜0.001）. Before NAC, the rates of age<50 years old and histological grade 3 in CD47 positive patients were higher than those in CD47 negative patients［70.0%（21/30） vs 38.7%（12/31）, 46.7%（14/30） vs 19.4%（6/31）］（both P＜0.05）, while there were no significant differences in other clinicopathological features (all P>0.05). Kaplan-Meier survival curve analysis showed that the overall survival and disease-free survival in CD47 positive patients were respectively longer than those in CD47 negative patients before NAC and after radical mastectomy based on NAC (all P>0.05). Conclusions   NAC can change the expression of CD47 in invasive breast cancer tissues. Before NAC, CD47 is more likely to express in patients age<50 years old and high histological grade, however, the expression of CD47 do not predict the prognosis of patients either before or after NAC.