MUC1在不同免疫表型乳腺癌组织中的强阳性表达及其与预后的关系

Strongly Positive Expression of MUC1 and Its Relationship with Prognosis in Different Immunophenotypes of Breast Cancer Tissues

目的探讨黏蛋白1(mucin1,MUC1)强阳性表达在不同免疫表型乳腺癌中对指导预后及个体化治疗的意义。方法采用免疫组织化学法检测335例乳腺癌组织中ER、PR和HER2的表达,将乳腺癌分为四个免疫表型,采用免疫组织化学法测定各免疫表型中MUC1的阳性及强阳性表达情况,并对其与不同免疫表型乳腺癌预后的关系进行统计分析。结果 335例乳腺癌患者中MUC1强阳性表达率为46.3%,MUC1强阳性表达患者5年总生存率低于非强阳性表达者,两者之间差异存在统计学意义(P<0.05)。335例乳腺癌中ER+/PR+、HER2-型130例,ER+/PR+、HER2+型64例,ER-、PR-、HER2+型67例,ER-、PR-、HER2-型74例;MUC1强阳性表达率分别为59.2%、56.3%、32.8%和27.0%,MUC1强阳性表达与乳腺癌免疫表型相关(P<0.01)。预后分组分析表明ER+/PR+、HER2-型,ER-、PR-、HER2+型乳腺癌患者中,MUC1强阳性表达患者5年总生存率低于非强阳性表达者,差异有统计学意义(P<0.05)。结论 MUC1强阳性表达与乳腺癌免疫表型相关,在不同免疫表型乳腺癌预后中的作用也有所不同,在ER+/PR+、HER2-型及ER-、PR-、HER2+型乳腺癌中MUC1强阳性表达提示预后较差。

Objective To explore the clinical significance of strongly positive expression（＋＋＋） of mucin1（MUC1） for prognosis and individual treatment in different immunophenotypes of breast cancer.Methods Three hurdred and thirty-five cases of breast cancer were categorized as follows： ER＋/PR＋,HER2-;ER＋/PR＋,HER2＋;ER-,PR-,HER2＋ and ER-,PR-,HER2-subtype.The expression levels of ER,PR,HER2 and MUC1 were detected by mean of immunohistochemistry and the relationship between the strongly positive expression of MUC1 and prognosis of breast cancer was analyzed.Results The strongly positive rate of MUC1 in 335 cases was 46.3 %,5-year overall survival rates（OS） of patients with strongly positive expression of MUC1 was lower（P〈0.05）.In 335 cases,ER＋/PR＋,HER2-subtype was 130,ER＋/PR＋,HER2＋ subtype was 64,ER-,PR-,HER2＋ subtype was 67 and ER-,PR-,HER2-subtype was 74.The strongly positive rate of MUC1 of four subtypes was 59.2%、56.3%、32.8% and 27.0%,respectively.The strongly positive rate of MUC1 has related to the immunophenotypes of breast cancer（P〈0.01）.5-year overall survival rates（OS） of patients with strongly positive expression of MUC1 was lower in ER＋/PR＋,HER2-and ER-,PR-,HER2＋ subtype（P〈0.05） by group analysis of prognosis.Conclusion The strongly positive expression of MUC1 was related to the immunophenotypes of breast cancer and played different role in prognosis of different immunophenotypes of breast cancer.The prognosis of patients with MUC1 strongly positive expression was poorer in ER＋/PR＋,HER2-and ER-,PR-,HER2＋ subtype.