FOXA1表达在乳腺癌分子亚型中的诊断及预后意义

Diagnostic and prognostic significance of FOXA1 expression in molecular subtypes of breast invasive ductal carcinomas

目的 观察乳腺浸润性导管癌中FOXA1的表达,以及在各分子亚型中的表达及其诊断、预后意义.方法 收集乳腺浸润性导管癌213例,应用免疫组化方法检测FOXA1、Ki67在各分子亚型中的表达情况,检测CK5/6、CK14用于区分正常乳腺样型和基底细胞样型.结果 213例乳腺浸润性导管癌中150例（70.4%）见FOXA1表达,FOXA1的表达与ER、PR呈正相关,与组织学分级、Nottingham预后指数、p53、Ki67呈负相关.FOXA1表达在Luminal亚型与非Luminal亚型之间表达有差异性.在Luminal亚型中,FOXA1的表达与组织学分级、PR、NPI和Ki67、Luminal A亚型有相关性.在预后方面：FOXA1的表达与长的无病生存期、总生存期有关.结论 在乳腺浸润性导管癌中FOXA1的表达与预后较好相关,FOXA1表达有可能被用于鉴别Luminal A亚型,亦可应用FOXA1在低风险乳腺癌中的预后意义来选择治疗方法.

Objective To investigate the expression of FOXA1 in breast invasive ductal carcinomas, observe its expression in all molecular subtypes of breast invasive ductal carcinomas and understand its diagnostic and prognostic significance. Methods Tissue specimens were obtained from 213 cases of breast invasive ductal carcinoma （IDC） and their expressions of FOXA1 and Ki67 detected by immunohistochemistry. And the expressions of CK5/6 and CK14 were detected to distinguish between normal breast-like subtype and basal-like subtype. Results The expression of FOXA1 was observed in 150 cases （70. 4%）. It correlated positively with ER and PR. But there was a negative correlation with histological grade, Nottingham prognostic index, p53 and Ki67. The expression of FOXA1 had difference between luminal and non-luminal subtypes. In luminal subtype, the expression of FOXA1 was associated with histological grade, PR, NPI, Ki67 and A subtype. In terms of prognosis, the expression of FOXA1 predicted a long disease-free survival and overall survival. Conclusion The expression of FOXA1 is associated with a good prognosis. FOXA1 is a promising candidate for clinical identification of luminal A subtype. Prognostic analysis of FOXA1 in low-risk breast cancers may prove to be useful in clinical treatment decision-making.