乳腺癌发生及其5年生存率与bag-1基因的表达(英文)

Effect of bag-1 expression on the occurrence of breast cancer and its 5-year survival rate

背景:bag-1是一种抗凋亡基因,其分泌蛋白是一种已经被确认的多功能结合蛋白。目前bag-1被认为可以作为早期诊断乳腺癌的一种生物标记,但其对乳腺癌预后的评估是否有意义?目的:探讨抗凋亡基因bag-1在乳腺癌组织中的表达及与预后的关系。设计:以乳腺癌、乳腺良性肿瘤及正常乳腺组织为研究对象的对照性实验。单位:解放军第四军医大学西京医院血管内分泌外科。材料:选择1995-05/2000-05手术切除的乳腺癌石蜡包埋组织块100例及2000-03/2000-05手术切除的10例乳腺良性肿瘤和10例正常乳腺组织石蜡标本作对照,以上均来自解放军第四军医大学西京医院病理科存档标本。方法:采用免疫组化链霉素-抗生物素-生物素-过氧化酶复合物法观察100例乳腺癌与10例乳腺良性肿瘤及10例正常乳腺组织的石蜡标本切片中bag-1的表达。主要观察指标:①乳腺癌、乳腺良性肿瘤及正常乳腺组织中bag-1表达水平。②不同bag-1表达水平乳腺癌患者的5年生存率。结果:bag-1在乳腺癌组织中、乳腺良性肿瘤中、正常乳腺组织中阳性表达率分别为85%,10%,10%,差异有显著性(χ2=29.98,P=0.00);在Ⅰ期、Ⅱ期、Ⅲ期的乳腺癌组织中bag-1阳性表达率分别为88%,82%,88%,差异无显著性(χ2=0.61,P=0.75);在导管癌、小叶癌及特殊型癌中bag-1阳性表达率分别为86%,85%,80%,差异无显著性(χ2=0.16,P=0.95)。对94例获随访的乳腺癌患者中,bag-1阳性表达者5年生存率为79%,bag-1阴性表达者5年生存率为9%,两者差异有显著性(χ2=0.07,P=0.04)。结论:bag-1在乳腺癌组织中高表达,bag-1在乳腺癌组织中的表达与肿瘤的临床分期,病理分型无关;bag-1可以作为乳腺癌预后的一个生物指标。

BACKGROUND:Bag-1 is a multifunctional and anti-apoptotic gene. Its anti-apoptotic ability is enhanced when binding to bcl-2 to form a complex. Now it is considered as a predictive biomarker for the early diagnosis of breast cancer. However, whether it is useful in the assessment of the prognosis of breast cancer is still elusive. OBJECTIVE: To explore the expression of bag-1 in breast cancer and its role for prognosis. DESIGN: A controlled study with breast cancer, benign breast tumor and normal breast tissues as subjects. SETTING:The Vascular and Endocrine Surgery Department of Xijing Hospital of the Fourth Military Medical University of Chinese PLA. MATERIALS:Totally 100 breast cancer specimens were obtained form May 1995 to May 2000.Ten benign breast tumor and 10 normal breast tissues were used as control.All the specimens were paraffin-embedded and came from the Pathological Department of Xijing Hospital Affiliated to Fourth Military Medical University of Chinese PLA. METHODS:Immunohostochemical strept avidin-biotin complex(SABC) method was adopted to detect bag-1 expression in these specimens. MAIN OUTCOME MEASURES:①The expression of bag-1 in these specimens. ②The 5-year survival rate of the patients with different expression levels of bag-1. RESULTS:The positive expression rate of bag-1 in breast cancer (85%) was significantly different form those of benign breast tumor (10%) and normal breast (10%) (χ2=29.98,P=0.00). While the positive expression rates in breast cancer of different stages (stageⅠ, stage Ⅱand stage Ⅲ) were 88%, 82%and 88%, respectively, which has no significant difference (χ2=0.61,P=0.75). In duct carcinoma, lobular carcinoma and special carcinoma, bag-1 positive expression rate was 86%,85%and 80%, which was also no significantly different (χ2 =0.16,P=0.95). In the 94 followed patients, the 5-year survival rate of positive bag-1 expression was 79%and that of negative bag-1 expression was just 9%. The difference was significant (χ2=0.07,P=0.04). CONCLUSION: High bag-1 expression exists in breast cancer and its level is not associated with the clinical stages or pathological types of the cancer. Therefore,bag-1 may be used as a predictive marker for the prognosis of breast cancer.