乳腺浸润性导管癌c-erbB-2等生物标志表达及其临床病理意义

Expressions of biomarkers in breast invasive ductal carcinoma and their clinicopathological significance

目的:研究生物标志c-erbB-2、c-erbB-1、FHIT、CyclinD1、Bcl-2、Bax、ER和PR在乳腺浸润性导管癌组织中的表达及其与乳腺癌患者无瘤生存时间和总体生存时间的关系。方法:用HE及SP免疫组染色法对100例乳腺浸润性导管癌作回顾性分析。结果:各生物标志的阳性率分别为ER60%,PR58%,c-erbB-224%,c-erbB-132%,FHIT73%,Cyclin D155%,Bcl-250%,Bax34%。单因素生存分析示,FHIT阳性表达的患者预后较好,Cyclin D1阳性的患者总体生存时间较长。Cyclin D1和ER均为阳性的患者预后好于均为阴性者(Pdfs=0.0108,Pos=0.0030)。c-erbB-2阳性者平均无瘤生存时间(43.5个月)和平均总体生存时间(51个月)均短于c-erbB-2阴性者,其无瘤生存时间和总体生存时间分别为77.5和117个月。c-erbB-1阳性者无瘤生存时间和总体生存时间均短于c-erbB-1阴性者(Pdfs=0.0000,Pos=0.0008)。ER及PR阳性者与阴性者无瘤生存时间差异均有统计学意义(PER=0.0322,PPR=0.0129),ER及PR阳性者无瘤生存时间更长。Bcl-2阳性者平均无瘤生存时间(83个月)和平均总体生存时间(124个月)均长于Bcl-2阴性者,其无瘤生存时间和总体生存时间分别为45和74个月。结论:ER、Bcl-2、FHIT、Bax和淋巴结受累、绝经情况是乳腺癌无瘤生存时间的独立预后因子;Bcl-2、c-erbB-2、c-erbB-1和淋巴结受累,是乳腺癌总体生存时间的独立预后因子。ER、PR、c-erbB-2、c-erbB-1、FHIT和Bcl-2与患者的无瘤生存时间相关。c-erbB-2、c-erbB-1、FHIT、Bcl-2和Cyclin D1与患者的总体生存时间相关。

OBJECTIVE：To investigate the expression of gene proteins ER, PR, c-erbB-2, c-erbB-1, FHIT, Cyclin D1, Bcl-2 and Bax and analyse their relevance to diseases free survival （DFS） and overall survival （OS） of patients and find out independent prognostic factors for DFS and OS of breast infiltrating ductal carcinoma. METHODS： HE staining and immunohistoehemical staining technology （SP） were used to do retrospective analysis for 100 cases of breast infiltrating ductal carcinoma. RESULTS：The positive expression rates of gene proteins were as following： ER 60%, PR 58%, c-erbB-2-24%, c-erbB-1 32%, FHIT 73%, Cyclin D1 55%, Bcl-2 50% and Bax 34%. Patients with FHIT positive tumor had longer DFS and OS. Patients with Cyclln D1 and ER positive tumor had better prognosis than those negative patients （Pdfs= 0.010 8, Pos = 0.003 0）. The mean DFS（43.5 months） and OS（51 months） of c-erbB-2 positive patients were shorter than those negative（77.5 and 117 months）. The same was to the overexpression of c-erbB-1 （Pdfs =0. 000 0, Pos = 0. 000 8）. Bcl-2 positive women had mean DFS of 83 months, mean OS of 124 months compared with 45 months and 74 months for Bcl-2 negative women. ER and PR positivity was significantly correlated with longer DFS （PER= 0. 032 2,PER=0. 012 9）. CONCLUSIONS,. FHIT, Bcl-2, ER, Bax, axillary node status, menopause or not are independent prognostic factors for DFS of breast infiltrating ductal carcinoma. c-erbB1, c-erbB-2, Bcl 2, axillary node status are independent prognostic factors for OS of breast infiltrating ductal carcinoma. ER, PR, c-erbB-2, c-erbB-1, FHIT and Bel-2 all show a significant correlation to DFS of breast infiltrating ductal carcinoma. c-erbB-1, c-erbB-2, FHIT, Bcl-2 and Cyclin D1 all show a significant correlation to OS of breast infiltrating ductal carcinoma.