DKK3蛋白与乳腺癌的临床病理及预后

DKK3 and its clinical significance in breast cancer and prognosis

目的:探讨DKK3(Dickkopf-3)蛋白在乳腺癌中的表达及其临床意义。方法:采用免疫组织化学方法检测DKK3蛋白在18例乳腺导管内乳头状瘤、14例乳腺非典型增生和103例乳腺癌中的表达,分析其与临床病理特征的关系。结果:在18例乳腺导管内乳头状瘤中,DKK3蛋白的高表达为14例,DKK3蛋白的高表达率为77.8%(14/18),在14例乳腺非典型增生中,DKK3蛋白的高表达为5例,DKK3蛋白的高表达率为35.7%(5/14);在103例乳腺癌中,DKK3蛋白的高表达为32例,DKK3蛋白的高表达率为31%(32/103),导管内乳头状瘤中的DKK3表达高于非典型增生中的DKK3表达(P<0.05),同时高于乳腺癌中的DKK3表达(P<0.01)。在乳腺癌中,DKK3的表达与患者的组织学分级、月经状态有关,而与患者的年龄、肿瘤大小、腋窝淋巴结转移、TNM分期、雌激素受体状态、孕激素受体状态、人表皮生长因子受体2状态无关。Kaplan-Meier生存曲线显示,DKK3高表达的乳腺癌患者总生存率明显高于低表达者(P<0.05)。结论:DKK3的表达降低可能在乳腺癌的形成中起到重要作用,DKK3可以作为一个判断乳腺癌预后的指标。

Objective To examine Dickkopf-3（DKK3） expression in breast cancer and to explore its clinical significance.Methods The expression of DKK3 in invasive breast cancer（n=103）,breast intraductal papilloma（n=18） and atypical ductal hyperplasia（n=14） was detected by immunohistochemistry.The correlation between DKK3 and clinical pathological data was explored.Results The ratios of high expression level of DKK3 protein in breast intraductal papilloma,atypical ductal hyperplasia and breast cancer were 77.8%,35.7% and 31.1%,respectively.There were significant differences between the breast intraductal papilloma and the atypical ductal hyperplasia（P0.05）,and between the breast intraductal papilloma and the breast cancer.In breast cancer,DKK3 expression was correlated with histological grade and menopausal status,but it was not related with the age,TNM stages,tumor size,estrogen receptor status,progesterone receptor status or human epidermal growth factor receptor status.Kaplan-Meier survival curve showed that the overall survival rate of patients with high expression of DKK3 was greater than those with low expression（P0.05）.Conclusion The lower expression level of DKK3 protein may play an important role in the development of breast cancer.DKK3 may be used as a maker for prediction of the prognosis of patients with breast cancer.