BSP和PTHrP的联合检测对乳腺癌骨转移临床意义的研究

Combined examination of the expression of BSP and PTHrP in detection of bone metastasis of breast cancer

目的:探讨骨唾液蛋白(BSP)和甲状旁腺相关蛋白(PTHrP)的联合检测对乳腺癌骨转移的临床意义。方法:乳腺癌87例患者,分为骨转移组40例和无骨转移组47例。应用免疫组织化学法检测石蜡包埋标本BSP和PTHrP的表达。结果:BSP和PTHrP在骨转移组的阳性表达均明显高于无骨转移组(χ2值分别为8.47和10.49,P均<0.01),且强阳性表达也均高于后者(χ2值分别为9.18和11.05,P均<0.05);同时两者在骨转移组的阳性表达与无转移组和骨外转移组之间比较,差异有统计学意义(P<0.01),而后两组间阳性表达差异无统计学意义(P>0.05)。Cox比例风险回归模型分析结果发现,乳腺癌组织中BSP和PTHrP的高表达是预测骨转移的主要危险因素(P<0.01),其相对危险度分别为1.293和1.348。Log-rank生存曲线分析结果显示,在乳腺癌患者中BSP和PTHrP高表达者的累积生存概率均明显低于BSP和PTHrP阴性表达组,P<0.05。结论:BSP和PTHrP的过表达是早期预测乳腺癌骨转移的良好标志,并可作为评估乳腺患者的一项重要的预后因子。

OBJECTIVE：To study the clinical significance of the expression of BSP and PTHrP in diagnosing bone metastasis of breast cancer tissues.METHODS：A total of 87 patients were included in this study.Patients were divided into 2 groups：bone metastasis group （n=40） and non-bone metastasis group （n=47）.The expression of BSP and PTHrP were measured by immunohistochemistry method （SP）.RESULTS：The expression of BSP and PTHrP in patients who developed bone metastases during the course of disease were significantly higher compared to patients without bone involvement （χ2 were 8.47 and 10.49,P0.01）,and the strong positive staining were also higher （χ2 were 9.18 and 11.05,P0.05）.In addition,It was found that BSP and PTHrP expression in patients having developed clinically diagnosed bone metastases was significantly increased than no any metastases and the other metastases except bone （P0.01）,but there was no difference between the latter groups （P0.05）.Cox analysis showed that the relative risk ratio for bone metastasis of higher expression of BSP and PTHrP were 1.293 and 1.348（P0.01）.Further analysis showed that the expression of BSP and PTHrP were important risk factors for patients with breast cancer to develop bone metastasis （P0.05）.CONCLUSION：BSP and PTHrP can be used as good markers for early diagnosis of bone metastasis,and may be an independent factor for predicting the prognosis of breast cancer.