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目的 研究他莫昔芬对乳腺癌患者的雌激素受体α36(ERα36)增强转移作用.方法 随机选取2010年1月至2015年1月入本院进行乳腺癌治疗的患者,将入选的200例患者随机分为试验组和对照组各100例.试验组口服他莫昔芬20 mg·d-1;对照组患者予以安慰剂,每天2片,每天1次.在治疗5d后,用荧光激活细胞分选仪分选取得ERα36细胞;用免疫组化技术检测ERα36的表达情况,对比2组患者乳腺癌的增殖转移能力和无转移生存期.结果 ERα36的阳性表达和肿瘤大小(小于2 cm的例数):试验组与对照组分别为42,53例;11,24例;组间比较差异均有统计学意义(均P＜0.05),表明ERα36的表达与乳腺癌细胞的恶化存在关联.试验组患者出现了58例转移,明显高于对照组的42例;试验组死亡28例,明显高于对照组的19例,差异均有统计学意义(均P ＜0.05).多元回归分析表明,相比未接受他莫昔芬治疗的患者,接受他奠昔芬治疗的患者的无转移生存期明显缩短.结论 他莫昔芬会使乳腺癌患者出现获得性和原发性耐药,对乳腺癌患者ERα36的增强转移起到了明显的不良作用.“,”Objective To investigate the effect of tamoxifen on the estrogen receptor α36 (ERα36) in breast cancer patients and its mechanism.Methods The patients with breast cancer treated from January 2010 to January 2015 were randomly selected.Among the 100 patients treated with tamoxifen,20 mg · d-1 tamoxifen was given daily for the treatment group.And receive starch slices of 100 patients,as the control group.After 5 d of treatment,ERα36 cells were sorted out of the breast cancer suppressor cell population of the two groups by fluorescence activated cell sorting device from the ERα36 membrane-targeting receptor.The expression of ERα36 was detected by immunohistochemistry.Then the proliferation and metastasis of ERα36 cells were compared between the two groups.Finally,combined with disease-free surial (DSF) and average no transfer surial (MFS) in two groups.Results The positive expression of ERα36 in treatment group and control group were 42,53 cases;the less than 2 cm in tumor size in the 2 group were 11,24 cases;comparison between two groups,the difference was statistically significant (all P ＜ 0.05).It indicating that the expression of ERα36 was associated with the deterioration of breast cancer cells.Of the treatment group of patients with 58 cases of metastatic cases,significantly higher than the control group of 42 cases,and the treatment group died in 28 cases,while the control group died in 19 cases,the difference was statistically significant between the 2 groups (all P ＜ 0.05).Multivariate regression analysis showed that tamoxifen treatment was negatively correlated with DFS and MFS in these patients.It indicating that compared with the absence of tamoxifen treatment,the prognosis of patients treated with tamoxifen was worse,and the mortality and metastasis were higher in patients treated with tafloxacin,the absence of metastatic survival of ERα36 tumors treated with tamoxifen was significantly shorter.Conclusion Selective tamoxifen will result in acquired and primary drug resistance in breast cancer patients,with significant side effects on ERα36 in patients with breast cancer.