活化白细胞黏附分子(ALCAM)在乳腺癌的表达及其临床意义

Expression and Clinical Significance of Activation of Leukocyte Adhesion Molecule(ALCAM)in Breast Cancer

目的：探讨活化白细胞黏附分子（ALCAM）在乳腺癌中的表达，及与临床病理特征和预后之间的关系。方法：选取接受并行乳癌改良根治术的150例乳腺癌患者纳入研究。采用免疫组织化学染色和Westernblot对ALCAM蛋白含量进行检测，并探讨其在不同临床病理特征病例中的表达差异。结果：ALCAM在乳腺癌组织中较乳腺癌旁组织中高表达，细胞膜ALCAM高表达的患者较低表达者更容易发生淋巴结转移（X2=15．910，P=0．010）和远处转移（X2=5．211，P=0．029）。细胞浆中ALCAM高表达的患者更容易发生局部复发（x2=7．379，P=0．012），尤其是短期内复发（〈2年）（x2=5．562，P=0．037），但与远期的局部复发（〉2年）无关。ALCAM蛋白与ER蛋白的表达密切相关（P=0．024）。细胞浆ALCAM染色强度高的患者要比低的具有更短的无病生存期（P=0．036）。结论：在乳腺癌中ALCAM高表达，其细胞膜上的ALCAM高表达可能使肿瘤细胞粘附能力减弱，促使肿瘤远处转移，而ALCAM细胞浆异位增强肿瘤的侵袭能力，从而促进肿瘤的进展。

Objective： To investigate the activation of leukocyte adhesion molecule （ ALCAM ） in breast cancer and the relationship between the prognosis and its clinicopathologic characteristics. Methods： Up to 150 breast cancer patients were included in the study. The patients all underwent parallel modified radical mastectomy. Immunohistochemical staining and Western blot analysis were used to detect the ALCAM protein content, and different clinical and pathologic features in cases of differential expression were explored. Results： ALCAM was highly expressed in breast cancer tissues. Patients with high ALCAM expression in the cell membrane had a higher incidence of lymph node metastasis （ X2 = 15.910, P= 0.010 ） and distant metastasis （ X2 = 5.211, P= 0.029 ）. High cytoplasmic ALCAM expression was correlated with local recurrence （ X2 = 7.379, P = 0.012）, especially short-term recurrence （ 〈2 years ） （ X2 = 5.562, P = 0.037 ）, but the long-term （ 〉2 years ） local recurrence was not significantly different. ALCAM protein expression was not correlated with ER protein expression （ P =0.024 ）. High cytoplasmic ALCAM staining intensity in patients was associated with low disease-free survival （ P= 0.036 ）. Conclusion： ALCAM is highly expressed in breast cancer. High ALCAM expression on the cell membrane may weaken the adhesion of tumor cells, and promote tumor metastasis. However, the ectopic positioning of cytoplasmic ALCAM enhances tumor invasion, thereby, contributing to tumor development.