乳腺癌改良根治术患者生物学指标的临床研究

A clinical correlation study among the expressions of biological parameters in breast cancer

目的:探讨乳腺癌改良根治术患者乳腺癌组织中ER、PR、C-erbB-2、Clusterin、p-gp表达之间的相关性。方法:免疫组化法检测48例乳腺癌改良根治术患者乳腺癌组织中ER、PR、C-erbB-2、Clusterin、p-gp的表达,应用数据挖掘技术对乳腺癌5种生物学指标进行分析。结果:48例乳腺癌改良根治术患者乳腺癌组织中,ER阳性率为43.8%,PR 35.4%,C-erbB-260.4%,Clusterin 62.5%,p-gp 41.7%,Ⅱ期p-gp、Clusterin表达的阳性率低于ⅢA期(P<0.05)。指标聚类分析提示,ER、PR和C-erbB-2之间具有较强的正相关性,它们与p-gp、Clusterin分别呈较弱的负相关性,而p-gp与Clusterin之间呈较强的正相关性。二阶段聚类分析结果提示,48例乳腺癌患者的5个分子标记物情况可分为3类:第1类:Clusterin(-)、p-gp(-)、C-erbB-2(+)和ER(+);第2类:Clusterin(+)、p-gp(+)和C-erbB-2(+);第3类:C-erbB-2(-)、ER(-)和PR(-)。结论:Clusterin和p-gp在乳腺癌中的表达与ER、PR和C-erbB-2的表达存在明显的差异且相关性弱,有可能是乳腺癌治疗的新靶点。

Objective：To explore the expressions of ER,PR,c-erbB-2,clusterin and p-gp in breast cancer patients with modified radical mastectomy and its clinical correlation.Methods：ER,PR,c-erbB-2,clusterin and p-gp were examined by immunohistochemical staining method in 48 cases of breast cancer,which of data were analyzed by data mining methods.Results：The positive rates of ER,PR,c-erbB-2,clusterin and p-gp were 43.8%,35.4%,60.4%,62.5% and 41.7%,respectively.The expression of clusterin and p-gp in clinical 2 stage for breast cancer were much lower than in clinical 3 stage（P〈0.05）.There were stronger correlations among ER,PR and c-erbB-2,which were weaker negative correlations with clusterin and p-gp with characteristic of stronger correlation.By 2-step clustering analysis,the five biological parameters were divided into 3 classes： clusterin（-）,p-gp（-）,c-erbB-2（＋） and ER（＋）;clusterin（＋）,p-gp（＋） and c-erbB-2（＋）;c-erbB-2（-）,ER（-） and PR（-）.Conclusion：There were conspicuous differences and weaker negative correlations between clusterin,p-gp and ER,PR,c-erbB-2.Clusterin and p-gp may play an important role in targeted therapy of breast cancer.