284例原发乳腺癌c-erbB2蛋白的表达及其与预后的关系

Expression of c-erbB2 protein and its relation to prognosis in 284 primary breast cancer patients

目的探讨c-erbB2癌蛋白在原发乳腺癌组织中的表达情况及其与预后的关系。方法采用免疫组化SP法检测284例原发乳腺癌组织的c-erbB2表达,并用统计学分析其与预后的关系。结果284例原发乳腺癌c-erbB2的阳性表达率为26.8%(76/284),其表达与淋巴结转移数目(P=0.003)密切相关。单因素分析表明,c-erbB2是总生存时间(OS,P=0.002)和无病生存时间(DFS,P=0.024)的重要预后因素;多因素分析表明,c-erbB2是影响OS(P=0.023)的独立预后因素。此外,c-erbB2阳性的肿瘤患者较阴性者更易于发生内脏转移。而对于不同的淋巴结转移和ER状态,c-erbB2也有不同的预后价值。结论c-erbB2是影响原发乳腺癌患者OS的独立因素;在不同的淋巴结转移和ER状态下,其预后价值不同。

Objective To investigate the expression of oncoprotein c-erbB2 in primary breast cancer and to analyze its relation to its prognosis. Methods Immunohistochemical staining for c-erbB2 was performed on paraffin-embedded specimens of primary breast cancer from 284 patients, and the relation to its prognosis was statistically analyzed. Results Positive expression rate of c-erbB2 was 26.8% （76/284） in 284 primary breast cancer patients. Expression of c-erbB2 was positively correlated with the status of lymph node metastasis （P = 0. 003 ）. Univariate analysis indicated that c-erbB2 expression is a significant prognostic factor for the disease-free survival （DFS） （ P = 0.024 ） and overall survival （OS） （ P = 0.002）, while multivariate analysis demonstrated that c-erhB2 is an independent prognostic factor for OS （P = 0. 023）. Moreover, tumors with c-erbB2 positive expression are more tend to metastasis to other viscera than those with c-erbB2 negative, c-erbB2 expression has different prognostic values for patients with different status of estrogen receptor （ER） and lymph node metastasis. Conclusion c-erbB2 expression is an independent prognostic factor for total survival time in primary breast cancer patients, and its prognostic values are different according to the different ER status and lymph node metastasis.