唾液酸化糖原分子和nm23-H1基因的表达与乳腺癌转移和预后的关系

Expression of sialylated carbohydrate antigens and nm23-H1 gene in prognosis of breast cancer

目的 :明确不同类型唾液酸化糖原分子 Sialyl Lewis A(Sle A)、Slalyl Lewis X(Sle X)的异常表达与乳腺癌转移和预后的关系 ,评价 Sle X和 nm2 3- H1基因表达的综合分析对乳腺癌预后判断的价值。方法 :采用免疫组织化学染色的方法 ,检测 10 2例乳腺癌组织内 Sle A、Sle X和 nm2 3- H1的表达 ,分析与乳腺癌转移和预后的关系。结果 :10 2例乳腺癌中 Sle A和 Sle X阳性率分别为 2 4 .5 % (2 5 / 10 2 )和 5 9.8% (6 1/ 10 2 ) ,nm2 3- H1低表达率为 37.3%(38/ 10 2 )。Sle A的表达与多项临床病理资料、淋巴结转移和预后之间无显著相关性。Sle X、nm2 3- H1基因的表达也与多项临床病理资料无显著相关性 ,但与淋巴结转移相关。生存曲线分析显示 ,Sle X阴性表达者的无瘤生存率明显高于 Sle X阳性表达者 ,P<0 .0 5 ;nm2 3- H1非低表达者的无瘤生存率明显高于 nm2 3- H1低表达者 ,P<0 .0 1。综合分析 nm2 3- H1表达和 Sle X表达与预后的关系显示 ,Sle X阳性表达合并 nm2 3- H1低表达的患者预后最差。多因素分析结果显示 ,原发肿瘤大小、淋巴结转移情况、联合 nm2 3- H1和 Sle X表达 ,为重要的独立判断预后的指标。结论 :以 Sle X为代表的 类糖原分子在乳腺癌中具有主要表达相关性 ,其表达与乳腺癌转移和预后不?

Objective: To assess the significance of expression of sialylated carbohydrate antigens and nm23-H1 gene in metastasis and prognosis of breast cancer. Method: Tissue specimens from 102 cases of primary breast cancer were stained with antibodies against sialyl Lewis A (SleA) and salyl Lewis X (SleX),and nm23-H1 proteins by immmunohistochemical methods. Result: Of the 102 cases,the positive cases of SleA and SleX were 24.5% (25/102) and 59.89% (61/102),respectively;the reduced expression of nm23-H1 was showed in 37.3% (38/102) of the cases. The positive expression of SleX and the reduced expression of nm23-H1 gene were significantly associa-ted with lymph node involvement. Among the 100 patients who underwent curative surgery,the disease-free survival rate was significantly correlated with nm23-H1 and SleX expression,respectively,but not with SleA expression. In multivariate analysis using Cox regression model,combination assay of nm23-H1 and SleX expression (emerged) as independent prognostic factors. Conclusion: These results suggest that nm23-H1 gene and SleX may be involved in the metastatic process in human breast cancer,and immunohistochemical detection of SleX and nm23(-H1) may be used as a biologic marker of prognosis.