Caspase-7在不同分子亚型乳腺癌中的表达及临床病理意义

Clinicopathological Significance of Caspase-7 Expression in Different Molecular Subtype of Breast Cancer

目的:探讨含半胱氨酸的天冬氨酸蛋白水解酶(cysteinyl aspartate specific proteinase,Caspase-7,CASP7)在不同分子亚型乳腺癌中的表达及临床病理意义。方法:应用免疫组织化学方法检测CASP7在254例乳腺癌组织中的表达,重点观察该蛋白在不同分子亚型乳腺癌组织中表达的差异及与临床病理指标间的相关性,Kaplan-Meier法分析该蛋白表达与乳腺癌患者预后之间的关系。结果:Caspase-7在ER+PR+HER2+、ER+PR+HER2-、ER-PR-HER2+、ER-PR-HER2-中阳性表达率分别为37.2%、60.3%、17.0%、40.0%,在ER+/PR+/HER2-型中表达最高,在ER-/PR-/HER2+型中表达低,四组总体表达差异具有统计学意义(P<0.001)。与ER、PR表达(均为r=0.194,P=0.002)呈显著正相关,与HER2表达2(r=-0.224,P<0.001)呈显著负相关。在ER-PR-HER2+型乳腺癌中,CASP7的表达与肿瘤大小呈负相关(P=0.028),且与术后纵膈转移和脑转移呈正相关(均为r=0.307,P=0.026)。CASP7的表达与乳腺癌患者生存无显著相关性。结论:CASP7在不同分子亚型乳腺癌中表达存在差异,并且可能作为乳腺癌分子分型和预后预测的候选标记物。

Objective: To investigate the expression and clinicopathological significance of cysteine peptidase 7 (Caspase-7, CASP7) in different molecular subtypes of breast cancer. Methods: The expression of CASP7 in 254 cases of breast cancer tissues were detected by using immunohistochemistry, the differences in CASP7 expression in different molecular subtypes of breast carcinoma and its correlation with clinicopathological factors were analyzed, Kaplan-Meier analysis was performed to analyze the relationship between CASP7 protein expression and prognosis of patients with breast cancer. Results: The positive expression rates of Caspase-7 in ER+PR+HER2+, ER+PR+HER2-, ER-PR-HER2+, ER-PR-HER2- were 37.2%, 60.3%, 17.0%, 40.0% respectively, which was strongest in ER+/PR+/HER2- and lowest in ER-/PR-/HER2+.(P<0.001). Caspase-7 expression was positively correlated with the expression of ER and PR (r=0.194, P=0.002), and was negatively correlated with the expression of HER2 (r=-0.224, P<0.001). In ER-PR-HER2+, CASP7 expression was related to tumor diameters(P=0.028) and postoperative mediastinal metastasis and brain metastasis(r=0.307, P=0.026). In this study, there was no relation between CASP7 expression and survival status of breast cancer patients. Conclusion: The expression of CASP7 in different molecular subtypes of breast cancer was different and had a certain clinical and pathological significance. It may be a candidate marker for the molecular classification and prognostic prediction of breast cancer.