乳腺癌原发肿瘤组织HES1、Her2、CXCR4及Survivin的表达及与术后复发、生存的关系

EXPRESSIONS OF HES1,HER2,CXCR4 AND SURVIVIN IN TUMOR TISSUES OF PRIMARY BREAST CANCER AND THEIR RELATIONSHIP WITH POSTOPERATIVE RECURRENCE AND SURVIVAL

目的探讨乳腺癌原发肿瘤组织发状分裂相关增强子1(HES1)、人类表皮生长因子受体2(Her2)、趋化因子受体4(CXCR4)及生存素(Survivin)的表达情况及与术后复发、生存的关系。方法选取河北中石油中心医院收治的原发性乳腺癌患者90例,均行乳腺癌改良根治术,将术中所取原发肿瘤病理组织及癌旁组织送检,检测并比较肿瘤组织与癌旁组织HES1、Her2、CXCR4及Survivin表达水平。根据患者术后复发情况将其分为复发组和未复发组,比较二组HES1、Her2、CXCR4及Survivin表达情况,并分析上述指标与患者术后生存的关系。结果原发肿瘤组织HES1、Her2、CXCR4及Survivin表达阳性率分别为53.33%、56.67%、46.67%、51.11%,均显著高于癌旁组织的11.11%、14.44%、10.00%、13.33%(P<0.05);肿瘤>3cm、腋窝淋巴结阳性、淋巴结转移个数>3个、临床分期为Ⅲ期的乳腺癌患者HES1、Her2、CXCR4及Survivin表达阳性率高于肿瘤≤2cm、腋窝淋巴结阴性、淋巴结转移个数≤3个、临床分期为Ⅰ~Ⅱ期的患者(P<0.05);复发组HES1、Her2、CXCR4及Survivin表达阳性率分别为73.17%、74.07%、63.41%、68.29%,均显著高于未复发组的36.73%、42.42%、32.65%、36.73%(P<0.05);HES1、Her2、CXCR4及Survivin阳性乳腺癌患者术后3年无瘤生存率较HES1、Her2、CXCR4及Survivin阴性患者呈明显下降趋势(P<0.05)。结论原发肿瘤病理组织中HES1、Her2、CXCR4及Survivin均呈高表达,且与患者肿瘤大小、腋窝淋巴结性质、淋巴结转移情况、临床分期及术后复发和无瘤生存存在相关性。

Objective To investigate the expressions of hairy enhancer of split homologues 1(HES1),human epidermal growth factor receptor-2(Her2),CXC chemokine receptor 4(CXCR4)and Survivin in tumor tissues of primary breast cancer and their relationship with postoperative recurrence and survival.Methods Ninety patients with primary breast cancer admitted to Hebei Petro China Central Hospital were selected for modified radical mastectomy.The pathological tissues and adjacent tissues of the primary tumors taken during surgery were submitted for examination,and the expression levels of HES1,Her2,CXCR4 and Survivin in tumor tissues and adjacent tissues were detected and compared.According to the postoperative recurrence,the patients were divided into the recurrence group and the non-recurrence group.The expressions of HES1,Her2,CXCR4 and Survivin were compared between the two groups,and the relationship between the above indicators and survival after surgery was analyzed.Results The positive expression rates of HES1,Her2,CXCR4 and Survivin were 53.33%,56.67%,46.67%and 51.11%in primary tumor tissues,which were significantly higher than 11.11%,14.44%,10.00%and 13.33%in adjacent tissues(P<0.05).The positive expression rates of HES1,Her2,CXCR4 and Survivin of breast cancer patients with tumors>3 cm,positive axillary lymph nodes,number of lymph node metastases>3 and clinical stage III were higher than those of patients with tumor≤2 cm,negative axillary lymph nodes,number of lymph node metastases≤3,and clinical stage I~II(P<0.05).The positive expression rates of HES1,Her2,CXCR4 and Survivin with73.17%,74.07%,63.41%and 68.29%of the recurrence group were significantly higher than 36.73%,42.42%,32.65%and 36.73%of the non-recurrence group(P<0.05).The 3-year tumor-free survival rate of patients with breast cancer of positive HES1,Her2,CXCR4 and Survivin showed a significant downward trend compared with that of patients with negative HES1,Her2,CXCR4 and Survivin(P<0.05).Conclusion HES1,Her2,CXCR4 and Survivin are all highly expressed in the pathological tissues of primary tumors,and they are correlated with tumor size,axillary lymph node property,lymph node metastasis,clinical staging,postoperative recurrence and tumor-free survival.