P53在三阴性乳腺癌中的表达及临床意义

The Expression of P53 in Triple Negative Breast Cancer and Its Clinical Significance

目的:探讨P53在三阴性乳腺癌中的表达及临床意义。方法:选取天津医科大学附属肿瘤医院2004年1月至6月间584例乳腺癌,用免疫组化方法检测患者中P53蛋白的表达状态,分析其与各临床病理特征的关系,以及在三阴性乳腺癌中的表达和预后作用。结果:乳腺癌患者中P53的阳性表达率为27.6%(161/584),其中三阴性乳腺癌中P53阳性表达率为35.9%,明显高于非三阴组24.8%(P=0.010)。在组织学Ⅲ级乳腺癌患者中,P53的阳性表达率为41.2%,明显高于Ⅰ和Ⅱ级中P53的阳性表达率,差异有统计学意义(P=0.001)。三阴性乳腺癌组P53阳性者较阴性患者易发生复发和转移(40%和18.7%,P=0.006),5年无瘤生存率明显降低(61.3%和78.6%,P=0.022)。在发生复发转移的三阴组和非三阴组乳腺癌患者中P53的表达差异无统计学意义(P=0.186)。P53的表达在年龄、月经状态、TNM分期、肿瘤大小、淋巴结状态等方面差异性无统计学意义(P>0.05)。结论:P53可以作为三阴性乳腺癌患者无瘤生存率的独立预后因素。

Objective： To investigate the expression of P53 in triple negative breast cancer and its relationship with the prognosis. Methods： A total of 580 breast cancer patients treated with surgery in Tianjin Medical University Cancer Institute and Hospital between January 2004 and June 2004 were reviewed. The expression of P53 and its prognostic value were evaluated with immunohistochemistry. Results： The expression rate of P53 was 27.6 % in all of the breast cancer eases （ 161/584 ）. Compared with non-triple negative breast cancer, triple negative breast cancer had a higer rate of P53 expression （ 35.5 % vs 24.8 %, P= 0.01 ）. P53 expression was higher in grade Ⅲ cancer than in grade Ⅰ and Ⅱ breast cancer （ P = 0.001 ）. Triple negative breast cancer patients with P53 expression were prone to have higer rate of relapse and metastasis （ 40 % vs 18.7 %, P= 0.022 ）. The 5-year disease free survival rate of P53 positive patients was lower than that of P53 negative patients （ 61.3 % vs 78.6 %, P = 0.022 ）. No significant difference was found in P53 expression between triple negative and non-triple negative breast cancer patients with recurrence and metastasis （ P = 0.186 ）. P53 expression was not related with age, menopause, TNM stge, tumor size, or lymph node metastasis （ P 〉 0.05 ）. Conclusion： P53 expression is an independent predictive factor for disease free survival of triple negative breast cancer patients.