乳腺癌细胞中p53、C-erbB-2、p21^(WAF1)和CDK4的表达及临床意义

Expression and clinical significance of p53,C-erbB-2,p21^(WAF1) CDK4 in breast cancer tissue

目的:探讨乳腺癌组织中p53、C-erbB-2、p21WAF1和CDK4的表达及临床意义。方法:采用免疫组化SP法检测120例乳腺癌组织石腊切片上p53、C-erbB-2、p21WAF1和CDK4的表达。结果:p53、C-erbB-2、p21WAF1和CDK4阳性表达率分别为53.3%、63.3%、58.3%、41.6%;阳性产物主要位于细胞核中,p53、C-erbB-2的表达与肿瘤组织分级(P<0.05)、淋巴结转移(P<0.01)显著相关,p21WAF1的表达与淋巴结转移(P<0.01)显著相关,无淋巴结转移组明显高于有淋巴结转移组;与组织分级及PR、ER表达无显著相关。CDK4阳性表达与肿瘤组织分级(P<0.05)、淋巴结转移(P<0.01)显著相关,与PR、ER无相关。结论:p53、C-erbB-2、p21WAF1和CDK4与乳腺癌的发生发展密切相关,可作为判断肿瘤浸润转移、指导治疗和估计预后的参考指标。特别是p53的表达水平及淋巴结转移可能是判断乳腺癌的术后生存的独立有效指标,而综合应用上述指标可能更有助于预后的判断。

Objective：To explore the expression and clinical significance of p53, C-erbB-2, p21^WAF1 and CDK4 in breast cancer tissue. Methods：The level of p53, C-erbB-2, p21^WAF1 and CDK4 were detected with immunohistochemical staining method in 120 breast tissues species. The relationship between p53, C-erbB-2, p21^WAF1, CDK4 and some clinicopathologic factors were analyzed. Results：P53, C-erbB-2, p21^WAF1, CDK4 were mostly expressd in nucleus with rates of 53.3% ,63.3%,58.3% ,41.6% respectively. The expression level of p53, C-erbB-2 was significantly correlated with histological grade （P 〈 0.05 ） and axillary lymph node metastases （P 〈 0.01）. The p21^WAF1 expression was related with lymph node metastasis （P 〈 0.01）, while not related with clinicopathologic characteristics such as histological grade, PR and ER status （P 〉 0.05）. The expression of CDK4 was correlated with histological grade（P 〈 0.01 ）. and lymph node metastasis status（P 〈 0.01 ）,while not correlated with PR and ER status（P 〉 0.05）. Conclusion： The gene products of p53, C-erbB-2, p21^WAF1, CDK4 play a key role in the oncogenesis and development of breast cancer. Their expression could be useful indexes to assess the malignant level and clinical prognosis of breast carcinoma. The expression of p53 and axillary lymph node metastases may be dependent prognostic indicators of operative survival for patients with breast cancer. The combined use of the above markers may be helpful in making a better estimation of prognosis.