C-erbB-2、Ki67、P53、CA15-3、AKP在乳腺癌骨转移患者中的表达水平及其相关性

Expression level of C-erbB-2, Ki67, P53, CA15-3 and AKP in breast cancer patients with bone metastases and its correlation

目的：分析乳腺癌发生骨转移时，Ki67、P53、C-erbB-2表达水平及血中CA15-3、AKP水平，并探讨其在乳腺癌发生骨转移时的临床应用价值。方法：选取49例乳腺癌骨转移患者作实验组，29例乳腺癌未转移患者作对照组。采用免疫组化法测定Ki67、P53和C-erbB-2表达水平，采用阳性率和阳性区域灰度值共同积分的方法统计Ki67、P53和C-erbB-2的表达量。化学发光免疫法检测CA15-3表达水平，生化速率法检测AKP表达水平。结果：乳腺癌未发生骨转移时Ki67、P53、C-erbB-2的平均表达量分别为1.07、1.03、0.41，发生骨转移时Ki67、P53、C-erbB-2的平均表达量分别为2.47、2.51，1.59。转移前后表达量相比具有显著性差异（Ki67,P＜0.01；P53,P＜0.001；C-erbB-2,P＜0.001）。乳腺癌未发生骨转移时，CA15-3、AKP表达水平为12.18、85.59，发生骨转移时表达水平显著升高，分别为25.81、123.57,和对照组相比具有显著性差异（CA15-3,P＜0.001；AKP,P＜0.01）。结论：Ki67、P53、C-erbB-2及CA15-3、AKP的检测对于乳腺癌发生骨转移的预测和诊断具有临床应用价值，其表达水平和骨转移具有很大相关性。

Objective：Analysis of bone metastasis in breast cancer, the Ki67, P53, C-erbB-2 expression level and CA15-3, AKP levels in the blood, and to explore its clinical application in breast cancer with bone metastasis. Methods：49 cases of breast cancer patients with bone metastases were selected as experimental group, 29 cases of breast cancer without metastasis patients as control group. The expression level of Ki67,C-erbB-2 and P53 were evaluated by immunohistochemical method. The expression of P53, Ki67 and C-erbB-2 were calculated by the positive rate and positive regional gray value. The level of CA15-3 and AKP were detected by chemiluminescence immunoassay and biochemical method.Results：The expression quantity of Ki67, P53, C-erbB-2 in breast cancer without bone metastases were 1.07, 1.03, 0.41. While its level in breast cancer with bone metastases were 2.47, 2.47, 1.59. There is significant difference in breast cancer between no bone metastases and bone metastases （Ki67, P〈0.01; P53, P〈0.001; C-erbB-2, P〈0.001）. The expression level of CA15-3, AKP in no bone metastases breast cancer were 12.18, 85.59. Compared with the control group with significant difference （CA15-3, P〈0.001;AKP, P〈0.01）, a significant rise in expression levels in bone metastases breast cancer, respectively 25.81, 123.57. Conclusions：The detection level of Ki67, P53, CA153, C-erbB-2 and AKP for prediction and diagnosis of bone metastases in breast cancer have clinical application value. Its expression level has great correlation with bone metastases.