乳腺浸润性导管癌中拓扑异构酶Ⅱ等相关因素表达与腋窝淋巴结转移的关系研究

Correlation of Expressions of Topoisomerase Ⅱ and Other Related Factors with Axillary Lymph Nodes Metastasis in Infiltrating Ductal Carcinoma

目的分析拓扑异构酶Ⅱ(TopoisomeraseⅡ)、nm23基因、雌激素受体(ER)、孕激素受体(PR)和C-erbB-2基因等在乳腺浸润性导管癌中的表达与腋窝淋巴结转移的关系,并探讨其临床意义,为进一步治疗、准确判断患者预后提供数据支持。方法采用免疫组织化学-SP法检测101例乳腺浸润性导管癌患者病理组织中的Topoi-someraseⅡ、nm23基因、ER、PR和C-erbB-2基因等,分析其与腋窝淋巴结转移的关系。结果 C-erbB-2(-)、(+)、(++)、(+++)4组的腋窝淋巴结转移发生率依次升高,分别为18.2%(2/11)、69.7%(23/33)、70.0%(21/30)、81.5%(22/27),差异有统计学意义(χ2=14.718,P=0.002)。TopoisomeraseⅡ(-)组腋窝淋巴结转移发生率(45.2%)低于TopoisomeraseⅡ(+)组(77.1%),差异有统计学意义(χ2=9.990,P=0.002)。而nm23(-)组腋窝淋巴结转移发生率(85.0%)高于nm23(+)组(55.7%),差异有统计学意义(χ2=9.404,P=0.002)。Logistic回归分析结果显示,TopoisomeraseⅡ(OR=8.870,P=0.001)、C-erbB-2(OR=1.848,P=0.041)是腋窝淋巴结转移的危险因素;而nm23(OR=0.151,P=0.008)是保护因素。结论 C-erbB-2基因和TopoisomeraseⅡ的阳性表达与腋窝淋巴结转移有关,nm23基因低表达患者腋窝淋巴结转移的危险较高。

Objective To research the expressions of TopoisomeraseⅡ , nm23 gene, ER, PR and C -erbB -2 gene in infiltrating ductal carcinoma and their relationship with axillary lymphatic metastasis. Methods The expressions of Topoi- somera Ⅱ, nm23 gene, ER, PR and C -erbB -2 gene were tested in 101 patients with infiltrating ductal carcinoma using im- munohistochemical methods, and their relationship with lymph node metastasis were analzyed. Results The incidence of axilla- IT lymph node metastasis increased in patients with C-erbB-2 （-）, （＋）, （ ＋ ＋）, and （ ＋ ＋ ＋） was 18.2% （2/11）, 69.7% （23/33）, 70. 0% （21/30）, and 81.5% （22/27） （χ2 = 14. 718, P =0. 002）. The metastasis rate was 45.2% in Topoisomerase Ⅱ （ - ） group, which was significantly lower than that in the Topoisomerase Ⅱ （ ＋ ） group （77. 1% ） （χ2 = 9. 990, P =0. 002）. The metastasis rate was 85.0% in nm23 （ - ） group, which was significantly higher than that in the nm23 （ ＋ ） group （55.7%） （χ2 = 9. 404, P = 0. 002 ）. Logistic multivariate analysis showed that Topoisomerase Ⅱ（ OR = 8. 870, P=0.001） and C-erbB-2 （OR=1.848, P=0.041） were risk factors whereas nm23 （OR=0.151, P=0.008） was the protective factors of axillary lymph node metastasis. Conclusion The positive expression of TopoisomeraseⅡ and C - erbB - 2 gene is associated with infiltrating ductal carcinoma axillary lymph node metastasis. Meanwhile, patients with low nm23 gene ex- pression may have higher risk of axillary lymph node metastasis.