凋亡抑制因子Livin在乳腺癌中的蛋白表达及与预后的关系

Protein expression of Livin in breast cancer and its correlations with prognosis

目的探讨凋亡抑制因子Livin在乳腺癌中的表达及与预后的关系,为乳腺癌的诊断、临床治疗及判断预后提供理论依据。方法用免疫组织化学SP检测50例乳腺癌、20例癌旁乳腺组织、10例非瘤正常乳腺组织中Livin的表达;结合临床病理特征和随访资料,建立Cox模型进行分析。结果 Livin蛋白在乳腺癌组织中的表达率为58.0%(29/50),在癌旁乳腺组织中的表达率为40.0%(8/20),在正常乳腺组织中表达率为0.0%,三者之间差异有统计学意义(P<0.05);在乳腺癌中,Livin的表达与临床分期、组织学分级、腋下淋巴结转移及ER受体状况均有显著相关(P<0.05),Livin的表达与年龄、肿瘤大小、远处转移及Her-2状况无显著相关(P>0.05);Livin低表达组患者的3、5和10年的生存率显著高于Livin高表达组患者,三者之间差异有统计学意义(P<0.05),多因素Cox回归分析显示,临床分期、组织学分级、腋淋巴结转移情况、远处转移及Her-2表达5项指标是影响患者生存率的独立危险因素。结论 Livin的异常高表达与乳腺癌的发生、发展及预后密切相关,提示Livin的表达可作为判断乳腺癌浸润进展及判断预后的指标之一。

【Objective】 To investigate the expression of the apoptosis inhibitor Livin in breast cancer and its correlations with prognosis and to provide a theoretical basis for breast cancer diagnosis,clinical treatment and prognosis.【Methods】 The expressions of Livin was detected by immunohistochemistry Streptavidin-Peroxidase method in 20 cases of adjacent-carcinoma,10 cases of normal tissues and 50 cases of breast cancer;with clinical and pathological features and follow-up data,the Cox model analysis was established.【Results】 The positive expression of Livin was 58.0%（29/50） in the tissues from breast cancer,whereas its positive rate was 40%（8/20） in the corresponding adjacent breast tissues,and none of the 10 normal tissue showed Livin expression,with statistical significance（P 0.05）;The expression of Livin in breast cancer was significantly related with clinical stage,histologic grade,auxiliary lymph node metastases and ER receptor status（P 0.05）;The expression of Livin did not show correlation to age,tumor size,distant metastasis and her-2 status（P 0.05）.3,5,10-year survival rates of patients with low expression of Livin were significantly higher than those of patients with high expression,statistically significant differences（P 0.05）.Multivariate Cox regression analysis showed that clinical stage,histological grade,auxiliary lymph node metastasis,distant metastasis,and Her-2 were the independent risk factors affecting the survival rate of patients.【Conclusion】 The abnormal expression of Livin is closely related to the development and prognosis of breast cancer,which suggesting that Livin expression could be used as one of indicators to determine the progress and prognosis of breast cancer.