L1-CAM在乳腺浸润性微乳头状癌的表达及其意义

Expression and significance of L1-CAM in invasive micropapillary carcinoma of the breast

目的:探讨L1细胞黏附分子(L1 cell adhesion molecules,L1-CAM)在乳腺浸润性微乳头状癌(Invasive micropapillarycarcinoma,IMPC)中的表达及其临床意义。方法:应用免疫组织化学SP法,检测97例乳腺IMPC中L1-CAM表达,并以95例浸润性导管癌非特殊型(invasive ductal carcinoma,not otherwise specified,IDC-NOS)作为对照组。分析L1-CAM在IMPC的表达及与临床病理学特征和预后的关系。结果:L1-CAM表达于肿瘤细胞膜及间质中的脉管内皮细胞,在IMPC组主要表达于肿瘤细胞集团内细胞间的相互连接面。L1-CAM在IMPC中的表达率(50.5%)显著高于IDC-NOS组(18.9%),并与IMPC的组织学分级、脉管侵犯、淋巴结转移、间质内脉管的L1-CAM表达及肿瘤细胞的P53表达呈正相关(P<0.05),与ER、PR表达呈负相关(P<0.05)。单因素分析结果显示,IMPC患者中L1-CAM表达阳性患者预后不良。多因素分析结果显示IMPC中L1-CAM表达是影响患者术后生存的独立预后因素。结论:L1-CAM可能在IMPC集团性生长、侵袭、转移中发挥重要作用,可作为IMPC预后预测的标志物及靶向治疗研究的新靶点。

Objective： The study aims to investigate the expression of L1 cell adhesion molecules （LI-tSAM） in invasion rrncropapmary carcinoma （IMPC） and to analyze its clinical significance. Methods： LI-CAM expression was analyzed in 97 IMPC cases and 95 invasive ductai carcinoma - not otherwise specified （IDC-NOS） cases via immunohistochemistry. The correlation of L1-CAM expression with clinicopathologic characteristics, which include the prognosis IMPC patients, was determined. Results： The rate of L1-CAM expression in IMPC （50.5%） is significantly higher than that of IDC-NOS （18.9%）. L1-CAM expression is also associated with histological grade, vessel invasion, lymph node metastasis, L1-CAM vessels, and protein p53 expression （P〈0.05）, whereas it is negatively associated with ER and PR （P〈0.05）. L1-CAM was predominantly expressed in the cell-cell interface of the cell clusters of IMPC and in the stroma vascular en- dothelial cells. Univariate analysis results indicate that expression of L 1 is a risk factor that can predict the survival of IMPC patients （P〈 0.05）. Multivariate analyses results from a Cox＇s proportional hazards model show that a high expression of LI-CAM is an independent risk factor for the death of IMPC patients. Conclusion： This study suggests that L1-CAM expression may have an important function in collective cell growth and is significantly associated with tumor invasion and metastasis. L1-CAM can be considered as biomarkers of prognosis and as a new target for IMPC therapy.