联合检测PTEN基因和雌激素受体对判断乳腺癌生物学行为和预后的价值

Clinical Value of the Expression of PTEN Gene,Progesterone Receptor and Estrogen Receptor for Predicting Biological Behaviors and Prognosis of Breast Carcinoma

目的探讨PTEN基因、ER和PR的表达水平对判断乳腺癌生物学行为和预后的临床意义。方法采用免疫组织化学SP法,检测石蜡包埋42例乳腺癌组织和12例乳腺小叶增生(对照组)中PTEN蛋白、ER和PR的表达水平,比较上述蛋白表达的差异及其与乳腺癌复发、转移、病理分级及生存情况的相关性。结果乳腺癌组PTEN高表达率低于对照组(P<0.05);PTEN基因在乳腺癌中的表达与肿瘤大小、肿瘤复发和病理分级无相关性(P>0.05);<45岁者PTEN高表达率明显低于>45岁(P<0.05);PTEN高表达的乳腺癌与腋淋巴结转移及远处转移呈负相关(P<0.01);PTEN高表达患者5年生存率明显高于PTEN低表达患者(P<0.01),且PTEN基因表达与ER受体呈正相关性(P<0.05),与PR表达无明显相关性(P>0.05)。结论乳腺癌患者PTEN基因低表达提示肿瘤易发生淋巴结及远处转移,其预后不良;联合检测ER和PTEN基因的表达可作为一种预测乳腺癌预后和转移趋势的指标。

Objective In recent study,PTEN gene,estrogen receptor and progesterone receptor were expressed in human breast cancer.The goal of this study was to observe the clinical value of relationship between the expression of PTEN,ER,and PR and the biological behaviors and prognosis of breast Cancer.Methods The expression of PTEN,progesterone receptor and estrogen receptor in 42 samples of paraffin embedded human breast cancer tissues,and 12 cases of paraffin embedded hyperplasia of mammary glands tissues were detected by immunohistochemistry（S-P method）.The differences in protein expression in breast cancer were compared and their relevance among recurrence,metastasis,tumor grade and survival was analyzed.Results The expression level of PTEN gene was less in breast cancer than in hyperplasia of mammary glands（P0.01）.The expression of PTEN gene was not related with tumor size,histological grade,clinical stage and postoperative recurrence;but the expression level was higher in the elder patients（45 years）than the younger（45 years）.The expression of PTEN in the patients with axillary lymph node and distant metastasis was significantly lower than patients with no metastasis disease（P0.01）;The expression of PTEN in breast cancer was according with the expression of ER,but had no relationship with the expression of PR.Further more,the level of the expression of PTEN was lower in patients with higher 5-year survival rate（P0.05）.Conclusion This study suggests that abnormal expression of PTEN gene plays a very important role in the tumorigenesis and development of primary breast carcinoma.Combined detection of PTEN and ER may be a effective strategy for predicting the biological behaviors and prognosis of breast cancer.