1267例乳腺癌临床与免疫组化指标的相关性分析

Correlation of Clinical Features with Immunohistochemical Indices of 1,267 Cases of Breast Cancer

目的:分析乳腺浸润性导管癌的临床特征及6种免疫组化指标表达的关系,探讨其临床意义。方法:采用免疫组化SP法对1267例乳腺癌患者的术后肿瘤石蜡标本进行ER、PR、C-erbB-2、P53、Ki-67、VEGF检测,并与患者的临床特征进行相关分析。结果:乳腺癌组织中ER、PR、C-erbB-2的阳性表达率分别为61.4%、53.0%、36.6%;P53、Ki-67、VEGF的阳性表达率分别为42.0%、91.6%、74.7%。肿瘤直径≤2cm组中,ER和PR表达率最高(66.8%和58.8%),而C-erbB-2的表达率最低(32.9%)。在低年龄组(≤50岁)和临床Ⅰ期的患者中,PR表达率均最高,为57.9%和58.5%。C-erhB-2在临床晚期(Ⅲ,Ⅳ期)表达率最高(45.9%)。P53、Ki-67的阳性表达均与ER阳性表达呈负相关。而P53、Ki-67、VEGF的阳性表达与C-erbB-2的表达均呈正相关。淋巴结阳性组中P53、Ki-67与ER及P53与C-erbB-2的相关程度均较淋巴结阴性组大。结论:乳腺浸润性导管癌组织中ER、PR、C-erbB-2与P53、Ki-67和VEGF之间有一定的相关性,联合检测有助于指导该类肿瘤的治疗。

Objective： To explore the correlation between the clinical characteristics and the expression of six immunohistoehemical indices in invasive duetal carcinoma of the breast （IDCB） and their clinical significance. Methods： The immunohistochemical SP method was used to detect the expression of ER, PR, C-erbB-2, P53, Ki-67, and VEGF in the postoperative paraffin blocks of 1267 ID- CB cases, and the positive expression rate was compared among the different subgroups. Results： The positive expression rates of ER, PR, C-erbB-2, P53, Ki-67, and VEGF among the 1,267 breast cancer cases were 61.4%, 53.0%, 36.6%, 42.0%, 91.6%, and 74.7%, respectively. Compared with the groups with larger tumors, the positive expression rates of ER and PR were both the highest in the groups with the small tumors （ ≤ 2 cm ）, and that of C-erbB-2 was the lowest. The expression rate of PR was 57.9% and 58,5%, respectively, in the groups with lower ages （ ≤ 50 years ） and early-stage tumors （ stage I ）, which ranked the first in both groups. The C-erbB-2 expression rate ranked the first among advanced patients, amounting to 45.9%. The positive expression of P53 and K.i-67 was negatively correlated with ER expression, whereas the expression of P53, Ki-67, and VEGF was positively correlated with C-erbB-2 expression. The correlation among the expression of ER, P53 and Ki-67, and between the P53 and C-erbB-2 expression were both higher in the positive lymph node group than in the negative lymph node group. Conclusion： There is a definite correlation of the expression ofER, PR, C-erbB-2 with P53, Ki67, and VEGF expression in the IDCB tissue. Unified detection will be of instructive significance in the therapy of IDCB patients.