p53、nm23和PCNA在临床Ⅰ期乳腺癌中的表达及其临床病理意义

Research on Expressions of p53,nm23and PCNA in StageⅠBreast Cancer and Their Clinical Pathology

目的:研究Ⅰ期乳腺癌p53、nm23和PCNA的表达,探讨其与预后的关系。方法:采用免疫组化S-P法检测138例Ⅰ期乳腺癌中p53、nm23、PCNA的表达。结果:p53阳性表达率为59.4%(82/138),其中髓样癌表达高于其它类型84.6%(11/13)。与病理类型、组织学分级无关(P>0.05),但与术后腋淋巴结转移密切相关(P<0.05)。淋巴结阳性p53与淋巴结阴性表达与生存期有明显差异(P<0.05)。nm23阳性表达率为82.6%(114/138),其中髓样癌、导管内癌100%表达(13/13、4/4),其次为导管癌早期浸润、管状腺癌、浸润性小叶癌、浸润性导管癌等,与病理类型、组织学分级相关,与腋淋巴结转移率呈负相关趋势,但无统计学差异(P>0.05)。PCNA阳性率为85.5%(118/138),PCNA平均指数为66.43±23.95,PCNA指数与组织学分级、淋巴结转移及预后有密切关系(P<0.01)。p53、nm23和PCNA协同表达观察结果显示,nm23与PCNA共同表达94例,且呈负相关;p53和PCNA共同表达37例,呈正相关;p53和nm23共同表达71例,且呈负相关;p53、nm23和PCNA协同表达62例,但与淋巴结转移及预后无关。结论:p53、nm23和PCNA在Ⅰ期乳腺癌有不同的表达,可作为反映Ⅰ期肿瘤增殖活性、侵袭力、预测预后的重要指标。为临床治疗提供参考依据。三者协同表达在肿瘤进展转移中的作用有待进一步研究。

Objective:To study the correlatuion of expression of p53,nm23,PCNA and the prognosis of stageⅠbreast cancer.Methods:Expressions of p53,nm23,PCNA were mea-sured in138cases of stageⅠbreast cancer by immunohistochemistry(S-P method).Results:Eighty-two of138cases(59.42%)showed p53positive and the positive rate in medullary cancer being84%(11/13)was higher than that in other types of tumor.There was no correlation with pathological type and histological classification(P>0.05),but had close relation with lymph node metastasis(P<0.05).Significant difference was observed between expression rate of p53positive and negative groups.The positive rate of nm23showed82.6%(114/138)and the expression rate in medullary cancer or ductal cancer was100%(13/13,4/4),There was no relation with its pathological type and histological classification(P>0.05),but had close relation with lymph node metastasis(P<0.05).PCNA positive rate was85.5%(118/138).The mean index of PCNA was 66.43±23.95,and PCNA expression had a close relations with its pathological type,histological classification,lymph node metastasis and prognosis(P<0.01).PCNA and nm23coordinately ex-pressed in94cases.p53and PCNA expressed in37cases,p53expressed in71cases,p53,nm23and PCNA expressed in62cases,and without relation with lymph node metastasis and its prognosis.Conclusion:The different expressions in stageⅠbreast cancer could be contributed to reflect proliferating activity,aggression and prognosis of the diseases,and it could be an important instruction in cancer treatment,but the mechanism of p53,nm23and PCNA coordination in the process of tumor aggression and metastasis need to be further researched.