胶质瘤相关癌基因蛋白-1预测乳腺癌复发转移的价值

Value of Glioma Oncogene Protein-1 in the Prediction of the Recurrence and Metastasis of Breast Cancer

目的:探讨乳腺癌病灶中胶质瘤相关癌基因蛋白-1(glioma oncogene protein-1,GLI-1)的表达水平与乳腺癌临床病理学特征及术后复发转移的关系。方法:分析221例有完整随访资料的乳腺癌患者的临床资料,在随访过程中出现转移、复发的42例患者作为复发转移组;从其余患者中随机抽取42例患者作为无复发生存组;另取确诊为良性乳腺肿瘤患者30例作对照组。用免疫组织化学技术检测乳腺癌和良性乳腺肿瘤患者原发病灶中GLI-1的表达水平,并分析其表达水平与乳腺癌临床病理学特征之间的关系,研究GLI-1在预测乳腺癌复发、转移中的作用。结果:复发转移组、无复发生存组84例患者中,乳腺癌病灶中GLI-1高表达59例(70.24%),低表达25例(29.76%);对照组患者原发病灶中GLI-1的表达为0例;乳腺良性肿瘤与乳腺癌病灶中GLI-1的表达差异有统计学意义(P<0.01)。恶性肿瘤病灶中GLI-1的表达水平与患者年龄、腋窝淋巴受累情况、肿瘤激素受体表达存在明显相关性(P均<0.05);肿瘤病灶中GLI-1的高表达与乳腺癌复发、转移密切相关[比数比(OR)=7.534,95%可信区间(95%CI)为2.104～26.974)];腋窝受累淋巴结数目不超过3个的乳腺癌患者(pN 0～3)中,原发病灶中GLI-1的高表达与肿瘤复发率、转移率增高明显相关(P<0.01);肿瘤病灶中GLI-1的高表达与患者术后出现肿瘤肝转移、骨转移密切相关(P<0.05);肿瘤病灶中GLI-1高表达的患者术后生存时间明显缩短(HR=1.852,95%CI为1.146～2.994)。结论:乳腺癌病灶中GLI-1的表达水平与乳腺癌的发生、复发、转移密切相关,并影响患者术后的总体生存时间。

Objective：To investigate the relationships between glioma oncogene protein-1（GLI-1） expression level and clinicopathologic features of breast cancer,and to explore the relevance of GLI-1 expression level with recurrence and metastasis of breast cancer after surgery.Methods：The completed follow-up clinical data of 221 patients with breast cancer was analyzed.Among them,42 patients with metastasis or recurrence of breast cancer were taken as relapse and metastasis group.Another 42 patients randomly selected from the rest of the patients were considered as relapse-free survival group.And 30 patients with benign breast tumor were considered as control group.Immunohistochemistry was used to detect GLI-1 expression level in breast primary lesions.Its relationships with clinicopathologic features of breast cancer were analyzed.Results： In the relapse and metastasis group and relapse-free survival group,the GLI-1 levels were high in 59 patients（70.24%） and low in 25 patients（29.76%）.In the control group,there was no GLI-1 expression.GLI-1 expression level was significantly different between benign breast lesions and malignant cancer lesions（P0.01）.In malignant leisions,GLI-1 expression level was significantly related with patients＇ age,axillary lymph node involvement,and tumor hormone receptor expression.High expression level of GLI-1 was closely related with the recurrence and metastasis of breast cancer（OR=7.534,95%CI： 2.104-26.974）.In breast cancer patients with no more than three axillary lymph node involvement,GLI-1 was high in the primary lesions,which was significantly associated with increased rates of recurrence and metastasis（P0.01）.The high expression level of GLI-1 in the tumor lesions was significantly associated with postoperative liver metastasis and bone metastasis.The overall postoperative survival time of patients with high expression of GLI-1 was significantly shorter（HR=1.852,95%CI： 1.146-2.994）.Conclusions： The expression level of GLI-1 in tumor leisions is closely related with the incidence of occurrence,recurrence and metastasis of breast cancer,and also related with the overall postoperative survival time of patients.