c-erbB-2、p53和Bcl-2蛋白表达在乳腺癌中的意义及其相关性的探讨

THE PROGNOSTIC VALUE AND CORRELATION OF c erb B 2 AND p53 AND Bcl 2 GENE PROTEIN EXPRESSION IN HUMAN BREAST CARCINOMA

目的 探讨乳腺癌中ｃｅｒｂ Ｂ２、ｐ５３ 和Ｂｃｌ２ 蛋白表达与临床病理参数、预后和增殖细胞核抗原（ＰＣＮＡ） 、雌激素受体（ＥＲ）、孕激素受体（ＰＲ）的关系。 方法 应用亲和素生物素复合物（ＡＢＣ） 法免疫组织化学技术对８７例福尔马林固定石蜡包埋的乳腺癌组织进行回顾性研究。 结果 （１）ｃｅｒｂ Ｂ２ 和ｐ５３ 这两种蛋白的超表达与淋巴结转移、病理分级、核分裂、生存期短、ＰＣＮＡ强阳性表达、ＥＲ、ＰＲ阴性表达等不良因素呈正相关趋势（ Ｐ＞ ０－０５） 。（２）Ｂｃｌ２ 的阳性表达与瘤细胞的分化、淋巴结无转移、生存期长，ＥＲ、ＰＲ 的阳性表达等良好因素相关联，而且Ｂｃｌ２的阳性表达常会“减弱”或“抵抗”原癌基因的不良因素。 结论 多种癌基因（ 包括ｃｅｒｂ Ｂ２、ｐ５３ 和Ｂｃｌ２）

PURPOSE The aim of the present study was to investigate the relationship between the gene protein expression of c erb B 2,p53 and Bcl 2 and clinical data,prognosis,PCNA Estrogen Receptor(ER) and Progesterone Receptor(PR),and to analyse the correlation among these three gene proteins in the prognostic determination of human breast carcinoma.METHODS 87 cases of formalin fixed paraffin embeded invasive breast carcinoma were retrospectly reviewed using ABC immunohistochemical method with the monoclonal antibody p53 and Bcl 2 and the polyclonal antibody c erb B 2. All the patients were followed up for 67.8 months.RESULTS (1)The gene protein over expression of p53 and c erb B 2 was significantly correlated with lymph node metastasis,pathologic classification,nuclear mitosis,short survival strong positive expression of PCNA and negative expression of ER and PR( P <0 05) were all factors of poor prognosis.Compared with c erb B 2, the over expression of p53 resulted in worse prognosis in breast carcinoma.(2) Factors of good prognosis,were the positive expression of Bcl 2 which was correlated with high grade,negative lymph node,long survive and the positive expression of ER and PR,which usually “reduced” and “resisted” the role of p53 and c erb B 2.CONCLUSIONS Many oncogenes might be involved in the development and progress of breast carcinoma.