乳腺癌组织中ER、PR、HER-2、BRCA-1的表达情况及与远期预后的关系

Expression of ER,PR,HER-2,BRCA-1 in Breast Cancer Tissues and Its Relation with Longterm Prognosis

目的研究乳腺癌组织中雌激素受体(ER)、孕激素受体(PR)、人表皮生长因子受体2(HER-2)、乳腺癌易感基因1(BRCA-1)的表达情况及与远期预后的关系。方法将2004年1月至2008年9月在绵阳市中心医院普外科接受乳腺癌根治术的350例患者纳入研究,通过免疫组织化学法检测乳腺癌组织中ER、PR、HER-2、BRCA-1的表达情况,随访患者的复发情况和存活情况。结果1 ER、PR、HER-1、BRCA-1的阳性率分别为58.0%、54.6%、45.1%、53.7%;2ER、PR、BRCA-1阳性患者的无瘤生存时间、3年存活率、5年存活率均高于阴性患者(P<0.01);HER-2阳性患者的无瘤生存时间、3年存活率、5年存活率均低于阴性患者P<0.01;3ER、PR、BRCA-1高表达是远期生存情况的危险因素,HER-2高表达是远期生存情况的保护因素。结论 ER、PR、HER-2和BRCA-1的表达情况可作为判断乳腺癌患者预后情况的可靠指标,4项指标联合检测可对患者的病情进行全面判断,并针对性的制订综合治疗方案。

Objective To study the expression of estrogen receptor（ ER）,progesterone receptor（ PR）,human epidermal growth factor receptor 2（ HER-2）,breast cancer type 1 susceptibility gene（ BRCA-1） in breast cancer tissues and its relation with long-term prognosis. Methods A total of 350 patients with breast cancer who received radical operation in General Surgery Department of Mianyang Central Hospital from Jan. 2004 to Sep. 2008 were enrolled and the expression of ER,PR,HER-2,BRCA-1 were detected by immunohistochemistry. Then recurrence and survival condition were followed up. Results 1 The positive rate of ER,PR,HER-1,BRCA-1 were respectively 58. 0%,54. 6%,45. 1%,53. 7%. 2Tumor free survival time,three year survival rate,five years survival rate of ER,PR,BRCA-1 positive patients were higher than those of negative patients（ P〈0. 01）; tumor free survival time,three year survival rate,five years survival rate of HER-2 positive patients were lower than negative patients（ P〈0. 01）. 3High expression of ER,PR,BRCA-1 were risk factors of long-term survival; high expression of HER-2 was protective factor of long-term survival. Conclusion Expression of ER,PR,HER-2 and BRCA-1 can be used as reliable index to judge the prognosis of patients with breast cancer,and the combined detection can provide comprehensive judgment on the condition of the patient to make targeted therapy.