乳腺癌ER、PR、PS2、C-erbB2、Ki-67联合检测的临床意义

The clinical significance of combined detection of ER,PR,PS2,C-erbB-2 and Ki-67 in patients with breast carcinoma

目的探讨乳腺癌雌激素受体(ER)、孕激素受体(PR)、PS2、C-erbB2、Ki-67联合检测的临床意义。方法收集2009年1月至2010年9月底收治并经病理科常规行免疫组织化学检测ER、PR、PS2、C-erbB-2、Ki-67的乳腺癌病例125例。分析患者的性别、年龄、肿瘤大小(取最大横径计算)、肿瘤性质(分类)、淋巴结转移情况、临床分期(TNM分期)及其与受体及相关检测(免疫组化采用SP法)结果及关系。结果 ER、PR、PS2、C-erbB-2的表达率分别为56.0%、64.0%、45.6%、78.4%;Ki-67低度增殖活性占71.2%,中高度增殖活性率28.8%。PR随肿瘤增大表达率下降(P<0.05)、Ki-67随年龄增高表达率下降(P<0.005)。结论乳腺癌ER、PR、PS2的检测对指导临床个体化内分泌治疗很关键;肿块较小者PR表达率较高、内分泌治疗相对更有效;年轻者增殖活性较高,对化疗相对敏感;C-erbB-2的免疫组化假阳性高,方法有待改进。

Objective To approach the clinical signifcance of combined detection of ER,PR,PS2,C-erbB2 and Ki-67 in breast carcinoma.Methods The data of 125 cases of breast carcinoma treated and underwent immunohistochemical detections of ER,PR,PS2,C-erbB-2 and Ki-67 from Jan 2009 to Sep2010 were collected.The receptor and related antibodys testing results and the correlations with the gender and age of the patients,tumor size（calculated according to the maximal transverse diameter）,cancer type,metastasis of lymphonode,and TNM staging were analyzed.Results The positive rates of ER,PR,PS2 and C-erbB2 were 56.0%,64.0%,45.6% and 78.4% respectively.Ki-67 assessment indicated that the lower and moderate to high proliferative activity were 71.2% and 28.8% respectively.PR positive rate decreased with the mass increase of the cancer（P0.05） and Ki-67 positive rate decreased with the increase of age（P0.005）.Conclusion The combined detection of ER,PR and PS2 may play an important role in guiding individual endocrine therapy of breast carcinoma.The patients with small mass of breast carcinoma show relatively high PR expression rate and the endocrine therapy is more effective in these patients.The younger patients exhibit high proliferative activity and they are relatively sensitive to chemotherapy.C-erbB-2 false positive rate in immunohistochemistry was high and the method needs to be improved.