乳腺癌细胞核形态定量分析与临床病理特征的关系

Relationship between nuclear morphometrical quantitative analysis and clinicopathological features of breast cancer

目的观察乳腺癌细胞核形态参数,探讨其与ER、PR、HER-2表达和临床病理特征的关系。方法收集388例乳腺癌标本,根据ER、PR和HER-2三种抗体的免疫组化标记结果,将乳腺癌分为管腔A(Luminal A)型、管腔B(Luminal B)型、HER-2过表达型和基底细胞样(Basal-like)型,各组行HE染色后通过图像分析软件测量细胞核参数,应用统计学分析各组间的差异,并通过电话或住院病例随访。结果各组乳腺癌细胞核等圆直径、面积及边缘周长差异有统计学意义(P均<0.05);ER+/PR+病例细胞核形态定量与ER-/PR-病例比较,差异有统计学意义(P<0.05);ER-/PR-病例组织学分级多为Ⅲ级,生存率低于ER+/PR+病例(P<0.05)。Luminal A型乳腺癌的无病生存期高于Basal-like型(P<0.05),总生存期高于HER-2过表达型(P<0.05)和Basal-like型(P<0.05)。结论乳腺癌细胞核形态定量差异有显著性,对其分子分型有一定的参考价值。ER、PR和HER-2免疫组化标记结合细胞核形态学测量结果对乳腺癌的治疗和预后的评估有重要意义。

Purpose To measure the nuclear morphological parameters of breast cancer to study the relationship between nuclear morphological parameters and ER,PR,HER-2 expression,and clinicopathologic features of breast carcinoma. Methods 388 cases of breast cancer specimens were collected and molecular classification was made according to ER,PR and HER-2 expression. the nucleus parameters were measured by image analysis software after HE staining. The difference among groups was statistically analysed,and follow-up was done by phone or by hospitalization. Results Among the 4 groups of breast cancer case,the differences of circle diameter,area and perimeter edges of the nucleus were statistically significant（ P 0. 05）. Nuclear morphometric quantitation between ER＋ / PR ＋ patients and ER- /PR- patients was statistically significantly differentice（ P 0. 05）. The majority of patients with ER- /PR- were histological grade Ⅲ and poor survival rate（ P 0. 05）. The disease-free survival in Luminal A type was higher than that of Basal-like type（ P 0. 05）,and its overall survival was higher than HER-2 over-expression（ P 0. 05） and Basal-like type（ P 0. 05）. Conclusion The nucleus morphological quantitation in breast cancer is of significant difference,which has certain reference value in its molecular typing. The result of ER,PR and HER-2 expression,combined with nuclear morphology measurement,are meaningful to the treatment and assessment of prognosis.