“三阴”型与非“三阴”型乳腺癌临床特征与E-钙黏蛋白表达的临床意义

Clinical significance of "three negative" and non-"three negative" breast carcinoma clinical features and E-cadherin protein expression

目的通过回顾性分析总结"三阴"型乳腺癌与非"三阴"型乳腺癌患者的临床病理特征、生物学特点以及两组E-钙黏蛋白表达情况来探讨其表达与乳腺癌转移及预后的相关性,以指导临床对于预后的判断。方法随机抽取笔者所在医院收治的经病理组织学确诊的乳腺癌患者病理组织113例,所有资料临床数据可溯源,且随访完整。采用统计软件对"三阴"型与"非三阴"型乳腺癌患者的临床病理学特点、复发转移、月经状况、E-钙黏蛋白表达等方面进行分析。结果"三阴"型与非三阴型乳腺癌患者相比,E-钙黏蛋白表达无明显统计学差异。但E-钙黏蛋白低表达者,生存曲线有下降趋势。logistic回归分析显示E-钙黏蛋白表达与腋窝淋巴结早期转移、远处转移部位多少、绝经状态以及ER表达状态差异有统计学意义(P<0.05);同时用COX风险模型多因素分析显示,本组患者腋窝淋巴结数目、远处转移部位多少为三阴及非三阴性乳腺癌预后不良的独立危险因素。Kaplan-Meier生存曲线显示ER阳性且E-钙黏蛋白低表达的非三阴乳腺癌生存时间缩短,差异有统计学意义(P<0.05)。结论"三阴"型乳腺癌与非"三阴"型乳腺癌E-钙黏蛋白表达低者预示生存时间缩短,同时E-钙黏蛋白表达与ER表达呈负相关性(P<0.05)。E-钙黏蛋白表达对于乳腺癌预后具有指导性意义。

Objective To explore the connection between E-cadherin’s expression and breast cancer metastasis and prognosis,through retrograde analytic summary the clinical pathologic feature and biological feature of triple-negative breast cancer and non-triple-negative breast cancer,and the E-cadherin expression of the two groups,to guide clinical evaluation of prognosis.Methods 113 cases of breast cancer pathologic tissues in the author’s hospital were randomly selected and had been diagnosed by histopathology.All the clinical datum had the origin and had get the full follow-up.Using analytic software to analyze the clinical pathologic feature regress and metastasis,menstruation,expression of E-cadherin of both TNBC and NTNBC.Results The E-candherin expression between the two groups had no significant difference.But the patients who had low express of E-cadherin,their survival curve on a downward trend.Logistic retrograde analysis showed that the expression of E-cadherin and armpit lymph node number,the number of long-term metastasis,menopause and ER expression condition had significant relation and there had analytic significance（P 〈 0.05）.At the same time,the COX risk model muti-factor analysis showed that：all above factors were the isolate risk factors for the poor-prognosis of both TNBC and NTNBC.Kaplan-Meier life curve showed that the NTNBC whose estrogen receptor was negative and had alow expression of E-cadherin had shorter life time.And the difference had analytic significance（P 〈 0.05）.Conclusion Both TNBC and NTNBC who have lower expression of E-cadherin mean that the shorten survival time,and the expression of E-cadherin has negative relation with the ER expression.