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유방의 침윤성관암종에서 다약제내성관련단백 및 P-당단백 발현과 99mTc-MIBI 세척률: 신보강화학요법에 대한 반응과의 상관관계
곽희숙 한국유방암학회 2007 Journal of breast cancer Vol.10 No.1
Purpose: Numerous non-invasive imaging methods for evaluating the chemotherapy response of breast cancer patients are currently being explored. The aim of present study was to investigate whether the washout rates (WRs) of 99mTc-MIBI could predict the response to chemotherapy in patients suffering with infiltrating ductal carcinoma using the expressions of multidrug resistance-related protein (MRP) and P-glycoprotein (Pgp). Methods: From May 2002 and March 2004, the patients were randomly and consecutively selected according to the results of immunohistochemical analyses of breast carcinoma specimens before the administration of neoadjuvant chemotherapy. A total 45 infiltrating ductal carcinomas in 45 female patients were selected and they were separated into three groups: group A consisted of tumors with both negative Pgp and MRP expressions (n=15); group B consisted of the tumors that were positive for either a Pgp expression or a MRP expression (n=15); group C consisted of the tumors that were positive for both Pgp and MRP expressions (n=15). All the patients were referred for double phase 99mTc-MIBI mammoscintigraphy after the injection of 925 MBq of 99mTc-MIBI to calculate the WR. The tumor response was evaluated after completion of neoadjuvant chemotherapy. The tumor response was classified as a complete or partial response (the responder group) and stable or progression (the non-responder group). All the patients underwent surgery. Results: The response rate of group C was lower than that of the other groups, but the difference was not statistically significant (p=0.283). The WR of non-responder group was lower than that of the responder group, although the difference was not statistically significant (p=0.674). The washout rates of group C was the highest than other groups and the difference was statistically significant (p=0.001). Conclusion: In conclusion, the WR of 99mTc-MIBI is helpful for in vivo determination of both the Pgp and MRP expressions for infiltrating ductal carcinoma of the breast.
곽희숙 부산대학교 병원 암연구소 2006 부산대병원학술지 Vol.- No.20
유방의 침윤관암종으로 신보강화학요법을 시행한 환자들을 대상으로 조기 및 지연 Tc-MIBI 유방스캔을 실시하여 WR을 구하고, 화학요법 후 종양의 반응을 조사하여 이와 관련한 근거를 탐구하고자 하였다. 신보강화학요법 후 반응군에 따른 Tc-MIBI의 WR은 반응군에 비해 비반응군에서 낮게 나왔으나 통계적인 유의성은 없었다(p=0.674). 본 연구는 P-당단백질 발현 여부를 같이 조사하지 않아 섣불리 결론을 내리기 힘들지만, Tc-MIBI 의 WR 만으로서 신보강화학요법의 반응률을 예측하는 데에는 아직 제한적일 것으로 생각되며, 이미 다른 연구에서 입증된 바 있는 P-당단백질 발현 및 다약제내성 유전자 발현과의 연관성을 입증한다면 비침습적인 방법으로 신보강화학요법에 대한 반응을 예측하는 데에 도움이 될 것으로 본다. Numerous non-invasive imaging methods in the evaluation of chemotherapy response of breast cancer are currently being explored. The aim of present study was to investigate whether the washout rates(WR) of Tc-MIBI could predict the response to chemotherapy in patients with infiltrating ductal carcinoma. Between January 2005 and October 2005, the patients were selected for neoadjuvant chemotherapy. A total 45 patients with infiltrating ductal carcinoma were referred to the double phase Tc-MIBI mammoscintigraphy after injection of 925 MBq of Tc-MIBI to calculate WR. Mter completion of neoadjuvant chemotherapy, the tumor response was evaluated. Tumor response was classified as complete or partial response(Responder group) and stable or progression(Non-responder group). All patients underwent surgery. The WR of non-responder group was lower than that of responder group although the difference was not statistically significant(p=0.674). In conclusion, the WR of Tc-MIBI only is not helpful for prediction of response after neoadjuvant chemotherapy in infiltrating ductal carcinoma of breast.