三阴性乳腺癌临床病理特征及与药物敏感度蛋白的相关性

Clinicopathologic Features of Triple Negative Breast Cancer and Their Correlation with Drug-sensitive Protein

目的比较三阴性乳腺癌与非三阴性乳腺癌患者的临床病理特征和药物敏感度蛋白相关性研究,分析对临床预后判断的意义。方法回顾性分析本院2010年1月至2012年10月初诊为乳腺癌的患者共227例,三阴性乳腺癌患者51例,非三阴性乳腺癌患者176例,统计分析两者临床病理学特征及药物敏感度蛋白表达的差异性。结果在临床特征方面,三阴性乳腺癌患者中绝经前发病率为60.8%,高于非三阴性乳腺癌的35.8%,差异有统计学意义(P<0.05);组织学Ⅱ级以上者64.7%,非三阴性乳腺癌组为40.9%,差异有统计学意义(P<0.05);在肿瘤大小、淋巴结是否转移、临床分期上两组相比差异并无统计学意义(P>0.05)。三阴性乳腺癌患者的TOPOⅡ低表达、β-tubulinⅢ高表达、ERCC1低表达、BRCA1和ERCC1共同低水平表达,与非三阴性乳腺癌相比差异均有统计学意义(P<0.05),而Ki67与BRCA1两组相比差异无统计学意义(P>0.05)。结论与非三阴性乳腺癌相比,三阴性乳腺癌患者具有在绝经前发病、组织分级较高等高危特点;TOPOⅡ低表达、β-tubulinⅢ高表达、ERCC1低表达以及BRCA1和ERCC1共同低水平表达与其临床预后及对药物敏感度有一定相关性,提示在临床预防、治疗和预后中可能有一定的指导意义。

Objective To compare the clinicopathologic features and the correlation with the drug-sensitive protein of the patients with triple negative breast cancer and those with non-triple negative breast cancer, and to analyze their clinical significance in predicting the prognosis. Methods We retrospectively analyzed 227 breast cancer patients who were newly diagnosed by Fuzhou General Hospital of Nanjing Military Command from January 2010 to Octorber 2012. Among which, 51 patients were with triple negative breast cancer and 176 patients were with non-triple negative breast cancer. The difference in clinicopathologic features and the expression of the drug-sensitive protein of the two groups was analyzed. Results Regarding clinical features, triple negative breast cancer patients who became morbid before menopause accounted for 60.8%, which was higher than non-triple negative breast cancer patients(35.8%)(P<0.05); as for histological grade, the patients with the histological grade higher than Grade Ⅱ accounted for 64.7%, while that of non-triple negative breast group was 40.9%(P<0.05); as for tumor size, lymph node status and clinical stage, there was no difference between two groups(P> 0.05). The low expression of TOPO Ⅱ, high expression of β-tubulinⅢ, low expression of ERCC1, and the low-level co-expression of BRCA1 and ERCC1 of the patients with triple negative breast cancer were all statistically different from those of the patients with non-triple negative breast cancer(P<0.05), while there was no significant difference between the two groups in terms of Ki67 and BRCA1(P > 0.05). Conclusion Compared with non-triple negative breast cancer patients, triple negative breast cancer patients had high-risk characteristics such as higher premenopausal morbidity and histologic grade, etc.The low expression of TOPO Ⅱ, high expression of β-tubulin Ⅲ, low expression of ERCC1, and the low-level co-expression of BRCA1 and ERCC1 had certain correlation with their clinical prognosis and drug sensitivity, indicating that they may be of some significance in the clinical prevention, treatment and prognosis.