孕激素受体a、b在乳腺浸润性导管癌中的表达及意义

Expressions of progesterone receptor a and b in breast invasive ductal carcinoma and their clinical significance

目的探讨孕激素受体a(PR-a)、孕激素受体b(PR-b)在乳腺浸润性导管癌(IDC)中的表达及其与各临床病理指标的相关性,探讨PR亚型与预后的关系。方法采用免疫组化法检测100例IDC组织中PR-a、PR-b的表达,分析其与雌激素受体α(ER-α)、雌激素受体β(ER-β)、人类表皮生长因子受体2(HER-2)、核增殖抗原Ki-67、淋巴结转移、细胞学分级、TNM分期及脉管癌栓的相关性,研究PR-a/PR-b比值与各指标的关系。结果PR-a阳性55例(55%),PR-b阳性58例(58%)。PR-a与HER-2、Ki-67的表达呈正相关(P<0.05),与淋巴结转移负相关(P<0.05),与ER-β及脉管癌栓负相关(P<0.01),与ER-α、细胞学分级、TNM分期无相关;PR-b与淋巴结转移、细胞学分级、TNM分期负相关(P<0.05),与HER-2、Ki-67及脉管癌栓亦呈负相关(P<0.01),与ER-α、ER-β无相关。PR-a/PR-b>1者32例(48.5%),=1者18例(27.3%),<1者16例(24.2%)。PR-a/PR-b>1组的HER-2、Ki-67、高细胞学分级、高TNM分期、淋巴结阳性率高于PR-a/PR-b≤1组(P<0.05)。结论 PR-b的表达与HER-2、Ki-67、淋巴结转移、细胞学分级、TNM分期及脉管癌栓均呈负相关,而PR-a与各指标的相关性各不相同,PR-b阳性及PR-a/PR-b≤1可作为IDC预后良好的指标。

Objective To investigate the expressions of progesterone receptor a and b in breast invasive ductal carcinoma（IDC） and their associations with clinical and pathological factors and prognosis. Methods The expressions of PR-a and PR-b in 100 specimen,; of IDC were detected by immunohistochemistry. The correlations between PR-a, PR-b and characteristics such as ER- a, ER- β, HER-2, Ki-67, axillary lymph node（ALN）metastases, cytological classification, TNM staging and lymphovascular invasion were analyzed, the relationships between PR-a/PR-b ratio and these factors were investigated. Results The expression rates of PR-a and PR-b were 55% and 58% respectively. The results showed positive correlation between PR-a and HER-2, Ki-67（P 〈 0.05）, and negative correlation between PR-a and ALN metastases（P 〈 0.05）, ER- 13, lymphovascular invasion（P 〈 0.01）, but irrelevant with ER- a, cytological classification, TNM staging. The results also showed that PR-b was negatively correlated with ALN metastases, cytological classification, TNM staging（P〈 0.05）, lymphovascular invasion, HER-2 and Ki-67 （P 〈 0.01）, although irrelevant with neither ER- a nor ER- β. The number of PFt-a/PR-b 〉 1, =1 and 〈 1was 32（48.5%）, 18（27.3%） and 16（24.2%） respectively. In PR-a/PR-b 〉 1 group, the positive rates of HER-2, Ki-67, high cytological classification, high TNM staging and ALN metastases were higher than PR-a/PR-b 〈 1 group（P 〈 0.05）. Conclusions The expression of PR-b is negatively correlated with HER-2, Ki-67, ALN metastases, cytological classification, TNM staging and lymphovaseular invasion. PR-b positive and PR-a/PR-b 〈 1 can be good indicators of prognosis for IDC.