乳腺浸润性导管癌中CD44v6分子的表达及其临床意义

Expression of CD44v6 Molecule in Breast Invasive Ductal Carcinoma and Its Significance in Clinic

目的检测乳腺浸润性导管癌中CD44v6分子的表达,探讨其与乳腺浸润性导管癌各临床病理特征的相关性、对预测乳腺浸润性导管癌患者预后的意义以及新辅助化疗对CD44v6分子的影响。方法用免疫组化染色法检测90例乳腺浸润性导管癌化疗前后及10例癌旁非肿瘤乳腺组织中CD44v6的表达,并对所有乳腺浸润性导管癌患者进行随访。结果乳腺浸润性导管癌组织中,CD44v6阳性表达率为81.1%(73/90),明显高于癌旁非肿瘤乳腺组织(0/10);CD44v6的表达与组织学分级、肿瘤大小、腋窝淋巴结转移及转移个数呈正相关,而与患者的年龄、月经状况、ER、PR、CerBb-2、P53之间无显著相关性;CD44v6阴性组的总体生存率明显高于CD44v6阳性组,且CD44v6阳性表达越强,患者总生存率越低;Cox比例风险模型多因素分析显示,CD44v6为影响预后的独立因素;介入化疗组和静脉化疗组化疗前后CD44v6的表达差异均无统计学意义。结论CD44v6分子在乳腺浸润性导管癌的诊断中具有较强的特异性;CD44v6分子可作为预测乳腺浸润性导管癌预后的指标之一,但不能作为判断新辅助化疗疗效的指标。

Objective To determine the expression of CD44v6 molecule in breast invasive ductal carcinoma （IDCa）, and explore the relationship of CD44v6 to clinical pathological characters of breast IDCa, the significance of CD44v6 in predicting the prognosis of patients as well as influence of neoadjuvant chemotherapy on CD44v6. Methods The expressions of CD44v6 molecule in 90 breast IDCa tissue specimens before and after chemotherapy and 10 para-tumor breast tissue specimens were determined by immunohistochemical staining, and all the patients with breast IDCa were followed-up. Results The positive rate of CD44v6 in breast IDCa tissues was 81. 1%（73/90）, which was significantly higher than that in para-tumor breast tissues（0/10）. The expression of CD44v6 was positively related to the histological grade, tumor size and metastasis in axillary lymph node, while showed no significant relationship to the age and menstrual status, ER, PR, CerBb-2 and P53. The total survival rate of CD44v6-negative patients was significantly higher than that of CD44v6-positive ones. The stronger the CD44v6 expression was, the lower the survival rate was. Cox model showed that CD44v6 was an independent prognostic factor of breast cancer. No significant differences were observed in the expression levels of CD44v6 in patients in intervention chemotherapy and vein chemotherapy groups before and after treatment. Conclusion CD44v6 molecule showed high specificity in diagnosis of breast IDCa, which might be used as an index for predicting the prognosis of patients. However, CD44v6 could not be used for evaluation of curative effect of neoadjuvant chemotherapy.