HER-2、PCNA、Bcl-2、Bax在乳腺癌组织中的表达与预后的关系

Correlations of HER-2,PCNA,Bcl-2,and Bax Expression to Prognosis of Breast Cancer

背景与目的:临床上在早期将具有高危因素及潜在转移危险的乳腺癌患者筛选出来并进行针对性的治疗是提高乳腺癌生存率、减少复发和转移的关键。本研究探讨人表皮生长因子受体2(human epidermal receptor 2,HER-2)、增殖细胞核抗原(proliferating cell nuclear antigen,PCNA)、Bcl-2、Bax的表达与乳腺癌患者预后的关系。方法:应用免疫组织化学EnVision二步法检测50例乳腺癌根治术后标本中HER-2、PCNA、Bcl-2、Bax蛋白的表达,结合5年随访资料分析上述指标与患者预后的关系。结果:乳腺癌组织中HER-2、PCNA、Bcl-2、Bax的阳性率分别为44.0%(22/50)、82.0%(41/50)、48.0%(24/50)、54.0%(27/50)。患者的中位生存期为62个月,5年总生存率为82.0%(41/50),无瘤生存率为38.0%(19/50)。单因素生存分析显示HER-2和Bax是乳腺癌复发的影响因素(P<0.001),多因素Cox模型分析显示HER-2和Bax是影响乳腺癌复发的独立因素(P<0.05和P<0.01),Bcl-2和Bax是影响生存期的独立因素(P<0.05)。结论:影响乳腺癌患者预后的独立因素有HER-2、Bcl-2、Bax,其中HER-2、Bax表达是预后不良的指标,Bcl-2表达是预后良好的指标。

BACKGROUND ＆ OBJECTIVE： Identifying breast cancer patients with high risk and treating them with relevant treatments is a key to improve their survival. This study was to investigate the correlations of human epidermal receptor-2 （HER-2）, proliferating cell nuclear antigen （PCNA）, Bcl-2, and Bax expression to the prognosis of breast cancer. METHODS： The expression of HER-2, PCNA, Bcl-2, and Bax in 50 specimens of breast cancer was detected by immunohistochemistry with EnVision staining. Their correlations to the survival time of the patients were analyzed. RESULTS： The positive rates of HER-2, PCNA, Bcl-2, and Bax in breast cancer tissues were 44.0%, 82.0%, 48.0% and 5410%, respectively. The median survival for the patients was 62 months, and the 5-year overall survival rate and disease-free survival rate were 82.0% and 38.0%, respectively. Univariate survival analysis suggested that HER-2 and Bax had significant influence on tumor recurrence （P〈 0.001）. Cox multivariate analysis indicated that the expression of HER-2 and Bax were correlated to regional recurrence and distant metastasis （P〈 0.05 and P〈 0.01 ）, and Bcl-2 and Bax proteins were independent predictors of overall survival （P 〈 0.05）. CONCLUSION. HER-2 and Bax are related to poor prognosis of breast cancer, while Bcl-2 is related to good prognosis.