乳腺癌组织ERβ表达与内分泌治疗效果和预后的关系

Correlation Between Expression of Estrogen Receptor Beta and Endocrine Therapy Result and Prognosis in Breast Cancer Patients

目的探讨ERβ表达对乳腺癌患者预后和内分泌治疗效果的影响。方法选取经根治性手术治疗的乳腺癌患者97例为研究对象。以回顾性研究为主,采用免疫组织化学S-P法测定乳腺癌组织中ERα、ERβ的表达。根据ERβ表达情况将患者分成ERβ阳性组(61例)和阴性组(36例),并结合临床病理指标和预后作对比分析。采用Kaplan-Meier法计算生存率,Log-rank法进行显著性检验,Cox模型行多因素分析。结果单因素分析结果显示ERβ阳性组患者的3年和5年累积生存率、无病生存率分别为93.44%、93.44%和83.61%、81.97%;ERβ阴性组患者3年和5年累积生存率、无病生存率分别为61.11%、55.56%和27.78%、27.78%。ERβ阳性组的3年、5年累积生存率及其无病生存率均高于ERβ阴性组,其差异具有非常显著性(P<0.01)。多因素分析结果显示ERβ、腋淋巴结转移、月经状况和ERα都是影响总生存率和无病生存率的独立因素(P<0.05或0.01)。ERβ阳性患者,行内分泌治疗后5年累积生存率和5年无病生存率(分别为91.18%和88.24%)均高于未行内分泌治疗的患者(分别为74.07%和74.07%),P<0.05或0.01。结论ERβ表达状况对乳腺癌患者预后的判断有一定价值,为独立的预后影响因素。ERβ阳性患者内分泌治疗有效。

Objective To find out the correlation between the expression of ERβ and the endocrine therapy result and prognosis in breast cancer patients. Methods 97 cases of primary breast cancer treated with operation were collected. Retrospective cohort study was used. ERa and ERβ were detected by S-P immunohlstochemical technique. The patients were divided into positive and negative group including 61 and 36 cases respectively according to ERβ expression. The data was analyzed combining with clinicopathological characters and prognosis using Kaplan-Meier method,Log-rank test and Cox regression.Results In univariant analysis the 3-year and 5-year overall and disease free survival rates were 93.44 %, 93.44 % and 83.61%, 81.97 % respectively in ERβ positive group ; 61.11%, 55.56 % and 27.78 %, 27.78 % respectively in ERβ negative group. The differences were all significant （P 〈 0.01 ）. In multivariants analysis ERβ,involved axillary lymph node number, menstrual state and ERα were the independent factors which might affect overall survival rates and disease free survival rates（P 〈0.05 or 0.01）. For ERβ positive patients, the 5-year overall and disease free survival rates in endocrine therapy group were 91.18% and 88.24% respectively superior to those in non-endocrine therapy group（74.07% and 74.07% ）. Conclusion ERβ is of value to assess the breast cancer patient＇s prognosis. It is an independent factor. Endocrine therapy is effective in ERβ positive breast cancer patients.