乳腺癌中HER-2、P16和P53的表达及预后意义

目的研究乳腺癌中HER-2、P16和P53蛋白表达及其对预后评估的意义。方法采用免疫组织化学法检测85例乳腺癌组织HER-2、P16和P53蛋白的表达。结果 (1)HER-2过表达阳性率为23.5%(20/85),P16和P53阳性的表达率分别为30.6%(26/85)和51.8%(44/85)。(2)HER-2与组织学分级相关(P<0.05);P16与年龄、ER、PR相关(P<0.05));P53与PR、P16相关(P<0.05)。(4)HER-2过表达阴性患者的无瘤生存率明显高于阳性患者,随着HER-2表达的增强,无瘤生存曲线下降(P<0.05),COX模型多因素生存分析结果显示,TNM分期,HER-2和P16是影响乳腺癌患者无瘤生存期的独立预后因素(P<0.05)。结论 HER-2、P16和P53与乳腺癌的发生发展密切相关,可作为指导治疗和估计预后的参考指标,特别是TNM分期,HER-2和P16是判断乳腺癌术后无瘤生存的独立有效指标。

Objective This study was to evaluate the prognostic significance of the expression of HER-2、P16 and p53 in patients with breast carcinoma.Methods HER-2、P16 and p53 protein levels in tumors from eighty five breast carcinoma patients were determined using immunohistochemistry analysis.Results （1）Of the 85 breast carcinoma, 20（23.5%）were found to be HER-2 over expression , 26（30.6%）were found to be P16 expression, and 44（51.8%）were found to be P53 expression.（2）There was significant correlation between the over expression of HER-2 and histological Grade（P〈0.05）. P16 expression was correlated with age , ER and PR（P〈0.05）. P53 expression was correlated with PR and P16 （P〈0.05）.（4）The disease-free survival （DFS）rate was significantly higher in HER-2-negative group than in HER-2-positive group. The DFS curve had a tendency to decline with the stronger expression of HER-2.（P〈0.05）. Cox＇s proportional hazards regression model revealed that HER-2 over expression, P16 expression, and TNM stage were independent prognostic factors of breast carcinoma （P〈0.05）.Conclusion The gene products of HER-2, P16 and P53 play a significant role in the oncogenesis and development of cancer, and may be used as reference indicator to judge direction therapy and predict prognosis. HER-2 over expression, P16 expression and TNM stage are independent prognostic parameters for postoperative DFS in patients with breast carcinoma.