整合素β样1 mRNA在乳腺原发癌中的表达及其临床意义

Expression of integrin beta-like 1 mRNA in primary creast cancer and its clinical significance

目的探讨乳腺原发癌组织中整合素β样1(integrin bate-like 1,ITGBL1)mRNA水平与临床病理因素的关系,评估其对预测患者预后的临床价值。方法采用实时定量RT-PCR方法检测180例行乳腺癌根治术并随访3年以上的乳腺浸润性导管癌组织中ITGBL1mRNA的水平。采用受试者工作特征(receiver operating characteristic,ROC)曲线确定ITGBL1 mRNA水平分组的阈值;用χ2检验比较组间差异;用Kaplan-Meier法绘制生存曲线;用Log-rank时序检验比较组间生存期的差异。结果ER阴性乳腺癌患者的ITGBL1 mRNA高表达率低于ER阳性患者(χ2=7.475,P=0.006),组织学Ⅲ级的乳腺癌患者ITGBL1 mRNA高表达率低于Ⅰ～Ⅱ级乳腺癌患者(χ2=4.410,P=0.036),而在不同年龄和绝经状态、肿瘤大小、淋巴结转移状态、临床分期以及PR和HER-2状态各组间比较差异无统计学意义(P>0.050)。ITGBL1 mRNA低表达组患者3年无转移生存率低于高表达组,差异有统计学意义(χ2=4.569,P=0.033);3年无病生存率、5年无病生存率和5年无转移生存率组间比较虽差异无统计学意义(P>0.050),但随ITGBL1 mRNA表达降低而有下降趋势。结论乳腺原发癌中ITGBL1 mRNA高表达是ER阳性乳腺癌的生物学特征之一;ITGBL1 mRNA低表达的乳腺癌恶性程度高、组织分化差且患者预后不良,提示ITGBL1基因是潜在的乳腺癌预后预测分子标志物。

Objective To clarify the relationships between ITGBL1 （integrin beta-like 1） mRNA expression and clinicopathological factors in breast cancer, and to evaluate its clinincal value in predicting the prognosis of breast cancer. Methods Real-time reverse transcription-polymerase chain reaction （RT- PCR） was used to detect the expression level of ITGBL1 mRNA in 180 cases of primary invasive ductal carcinoma, who underwent radical mastectomy and were followed up for at least 3 years. Receiver Operating Characteristic（ROC） curve was used to identify the cut-off value of ITGBL1 mRNA level to group the patients. Chi-square test was used to compare differences between groups. Survival analysis was carried out using Kaplan-Meier analysis. Log-rank test was used to compare the differences of survival rates between groups. Results The high expression rate of ITGBL1 mRNA in ER-negative breast cancer patients was lower than in ER-positive breast cancer patients （χ^2 = 7. 475, P= 0. 006）, lower in histological grade Ⅲ breast cancer patients than in histological grades Ⅰ and Ⅱ breast cancer patients （χ^2=4. 410, P=0. 036）; No statistically significant difference was observed between groups in age, menostasis status, tumor size, lymph node status, clinical stage and the status of PR and HER-2 （χ^2 = 4. 569, P= 0.033 ）. Three-year and 5-year disease-free survival and 5-year metastasis-free survival of cases had no statistical differences between groups. （P〉0. 050） , but with decrease of the ITGBL1 mRNA expression, there was a decrease trend in survival. Conclusions High expression level of ITGBL1 mRNA is one of the biological characteristics of ER positive breast cancer. Patients with low expression of ITGBL1 mRNA have higher degree of malignancy, poor differentiation, and poor prognosis, indicating ITGBL1 mRNA is a potential molecular marker for predicting prognosis of breast cancer.