乳腺癌Her-2基因过表达与年龄 临床病理状态的相关性研究

Relationship between Her-2 Overexpression and Clinicopathological Status in Breast Cancer

目的:探讨乳腺癌Her-2过表达与年龄、临床病理状态的关系。方法:选取天津医科大学附属肿瘤医院2002年7月～2005年11月4773例原发性乳腺癌,患者年龄15～92岁,中位年龄50岁。均经手术切除病理组织学证实。采用免疫组化SP法进行ER、PR、Her-2、p53、PCNA检测。中位随访时间40个月。结果:3994例进行Her-2检测,Her-2阴性2930例(73.4%),Her-2过表达1064例(26.6%),其中Her-2(++)621例(15.5%),Her-2(+++)443例(11.1%)。绝经前Her-2过表达率26.5%,绝经后Her-2过表达率26.8%;Her-2过表达在腋淋巴结阴性者中占24.3%,腋淋巴结阳性者中占29.6%。Her-2过表达与年龄呈负相关,与腋淋巴结数目呈正相关。Her-2过表达与肿瘤大小、临床分期、病理类型、组织学分级无相关性。但绝经前、腋淋巴结阳性1～3个或ER阳性或PR阳性时,组织学分级与Her-2过表达呈正相关;绝经后、ER阳性或PR阳性时,临床分期与Her-2过表达呈正相关。结论:年龄、腋淋巴结情况是Her-2过表达的独立影响因素。而肿瘤大小、临床分期、病理类型、组织学分级均与Her-2过表达无关,仅在一定临床病理条件下对Her-2过表达存在影响。

Objective： To observe the relationship between expression of Her-2 in breast cancer and clinicopathologic status. Methods： Data from 4773 primary breast cancer eases seen in Tianjin Cancer Hospital from July 2002 to November 2005 were collected. The age of patients ranged from 15 to 92 years old, and the median age was 50. All of the cases were confirmed as breast cancer by pathohistology. Expression of ER, PR, Her-2, P53, and PCNA was measured by immunohistochemistry （IHC）. Median follow-up period was 40 months. Results： Her-2 protein expression was detected in 3994 cases. Her-2 overexpression was observed in 1064 cases （26.6%）, with 15.5% showing moderate overexpression and 11.1% showing dramatic overexpression. Her-2 overexpression was observed in 26.5% of premenopausal cases and 26.8% of postmenopausal cases; it was seen in 24.3% of node-negative and in 29.6% of node-positive cases. Her-2 overexpression was positively correlated with axillary lymph node status and negatively correlated with age; it had no correlation with clinical tumor stage, histological grade, tumor size or pathologic type. For some cases with a specific clinicophathological status, Her-2 overexpression is correlated with tumor stage and histological grade. Conclusion： Axillary lymph node status and age can be used as independent predictors for Her-2 overexpression.