乳腺癌组织及区域淋巴结ADM表达的研究

Expression of Adrenomedullin in Breast Cancer and Local Lymph Nodes

目的:探讨肾上腺髓质素(Adrenomedullin,ADM)在乳腺癌组织中的表达情况及其与临床生物学行为的相关性。方法:应用免疫组织化学方法检测69例乳腺癌、139枚区域淋巴结和10例乳腺腺病组织的ADM表达情况,并回顾性分析ADM表达与乳腺癌的临床生物学行为的关系。结果:69例乳腺癌组织中ADM均为阳性表达(+++:37例,++:21例,+:11例,-:0例),10例乳腺腺病均为弱阳性(+)表达,二者表达比较有显著差异(P<0.05)。ADM在乳腺癌组织中的表达与其组织学分级显著相关(P=0.026),组织学Ⅰ级的表达低于Ⅱ级(P=0.047)和Ⅲ级(P=0.005),而与月经状态、肿瘤大小、病理类型、淋巴结状况、TNM分期、ER/PR状态和预后无关。其中10例乳腺癌所属腋淋巴结共139枚,81枚癌转移的淋巴结均为ADM阳性表达,58枚无转移者均为阴性,二者比较有显著性差异(P=0.000)。结论:乳腺癌组织中ADM的表达明显增强,其表达水平和肿瘤组织学分级显著相关;癌转移的淋巴结ADM呈阳性表达。

Objective： To investigate the expression of adrenomedullin （ADM） in human breast cancer and to evaluate its clinical significance. Methods： Immunohistochemical staining was performed to examine the expression of ADM in 69 cases of breast cancer, 139 local lymph nodes and 10 breast adenosis tissues, and the relationship was retrospectively analyzed between the expression of ADM in breast cancer and the clinicobiological features. Results： Positive expression of ADM was found in all 69 cases of breast cancer （＋＋＋37, ＋＋21, ＋11,-0）. Ten adenosis tissues showed weak staining intensity. Significant difference was found between the two groups （P〈0.05）. There was a significant relationship between the expression of ADM and the grade of breast cancer （P=0.026）. The expression of ADM in grade Ⅰ was lower than that in grade Ⅱ （P=0.047） and Ⅲ （P=0.005）. No relationship was found between the expression of ADM and the menopausal status, tumor size, histological type, nodal status, TNM stage, EP/PR or prognosis. In 10 breast cancer patients, 139 lymph nodes were found, of which 81 metastatic nodes were positive for expression of ADM and 59 nodes that were not involved were negative for ADM expression. Significant difference was found between them （P=0.000）. Conclusions： Compared to non-cancerous tissue, breast cancer showed increased expression of ADM and this expression was associated with grade. Positive expression of ADM was also found in metastatic lymph nodes.