بروز ژن PTEN و مقاومت به درمان با تاموکسیفن در بیماران سرطان پستان با گیرنده استروئیدی مثبت، یک مطالعه مقطعی طی سال 95-1385

نوع مقاله : اصیل پژوهشی

نویسندگان

1 دستیار تخصصی بالینی، کمیته تحقیقات دانشجویی، دانشکده پزشکی، دانشگاه علوم پزشکی مشهد، مشهد، ایران.

2 استاد گروه آسیب‌شناسی، دانشکده پزشکی، دانشگاه علوم پزشکی مشهد، مشهد، ایران.

3 دانشیار گروه رادیوتراپی و انکولوژی، مرکز تحقیقات سرطان، دانشکده پزشکی، دانشگاه علوم پزشکی مشهد، مشهد، ایران.

4 دانشیار گروه پزشکی اجتماعی، دانشکده پزشکی، دانشگاه علوم پزشکی مشهد، مشهد، ایران.

چکیده

مقدمه: مسیر PI3K/Akt/mTOR در ایجاد مقاومت به درمان هورمونی بیماران مبتلا به سرطان پستان از اهمیت به‌سزایی برخوردار است. یکی از اجزای تنظیم‌کننده این مسیر، ژن PTEN می‌باشد. مطالعه حاضر با هدف مقایسه بروز ژن PTEN در بیماران سرطان پستان با گیرنده استروئیدی مثبت در دو گروه بیماران حساس و مقاوم به تاموکسیفن انجام شد.
روش‌کار: این مطالعه مقطعی و گذشته‌نگر بر روی 80 نفر از بیماران مبتلا به سرطان پستان هورمون مثبت که طی بازه زمانی 95-1385 به درمانگاه‌های انکولوژی وابسته به دانشگاه علوم پزشکی مشهد مراجعه کرده‌ بودند، انجام گرفت. نمونه بافتی بیماران حساس و مقاوم به درمان به تاموکسیفن (وقوع عود/متاستاز طی 5 سال اول درمان هورمونی ادجوانت) توسط ایمونوهیستوشیمی از نظر وجود بیان PTEN بررسی شد. تجزیه و تحلیل داده‌ها با استفاده از نرم‌افزار آماری SPSS (نسخه 16) و آزمون­های تی مستقل، یو من ­ویتنی و کای­اسکوئر انجام شد. میزان p کمتر از 05/0 معنادار در نظر گرفته شد.
یافته‌ها: در این مطلعه 80 بیمار در دو گروه حساس و مقاوم به تاموکسیفن وارد شدند. بروز PTEN در بیماران حساس و مقاوم به تاموکسیفن به‌ترتیب 5/97% و 5/27% بود (001/0=p). در بیماران با وضعیت درگیری گره‌های لنفاوی پیشرفته‌تر، میزان بروز PTEN به­طور معناداری کاهش یافته بود (001/0=p)، در حالی‌که در بررسی بین بروز PTEN با سایز تومور (19/0=p)، گرید تومور (14/0=p) و بروز Her2/neu (85/0=p) ارتباط معناداری مشاهده نشد.
نتیجه‌گیری: بین فقدان بروز PTEN و مقاومت به درمان با تاموکسیفن همراهی وجود دارد.

کلیدواژه‌ها

عنوان مقاله [English]

PTEN Gene Expression and Tamoxifen-Resistance in Steroid Hormone Receptor Positive Breast Cancer Patients, a cross-sectional study between 2006 and 2016

نویسندگان [English]

  • Fereshteh Mohammadi Daloyi 1
  • Noorieh Sharifi 2
  • Fatemeh Homaei Shandiz 3
  • Lida Jarahi 4
1 Resident, Department of Clinic, Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
2 Professor, Department of Pathology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
3 Associate Professor, Department of Radiotherapy and Oncology, Cancer Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
4 Associate Professor, Department of Community Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
چکیده [English]

Introduction: PI3K/Akt/mTOR pathway is important in inducing resistance to hormone therapy in patients with hormone positive breast cancer. One regulator of this pathway is the PTEN gene. This study was performed with aim to compare the expression of PTEN gene in hormone receptor positive breast cancer patients between patients with sensitive and resistant to tamoxifen.
Methods: This cross-sectional and retrospective study was performed on 80 hormone receptor positive breast cancer patients who had referred to oncology clinics of Mashhad University of Medical Sciences from 2006 to 2016. Tissue samples of tamoxifen-sensitive and -resistant patients (recurrence/metastasis occurring during the first 5 years of adjuvant hormone therapy) were immunohistochemically evaluated for PTEN expression. Data were analyzed by SPSS software (version 16) and Independent t-test, U Mann-Whitney and chi-square tests. P<0.05 was considered statistically significant.
Results: In this study, 80 patients were evaluated in two groups of tamoxifen sensitive and resistant. The expression of PTEN in tamoxifen-sensitive and resistant patients was 97.5% and 27.5%, respectively (p=0.001). However, in patients with more advanced lymph node involvement, the expression of PTEN was significantly reduced (p=0.001), there was no significant relationship between PTEN expression and tumor size (p=0.19), tumor grade (p=0.14) and Her2/neu expression (p=0.85).
Conclusion: There is association between PTEN gene expression and tamoxifen resistance.

کلیدواژه‌ها [English]

  • Breast Cancer
  • Steroid Hormone Receptor Positive
  • Tamoxifen
  • Hormone Therapy Resistance
  • PTEN

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مجله زنان، مامایی و نازایی ایران
دوره 23، شماره 2
اردیبهشت 1399
صفحه 9-19

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