雌激素受体、孕激素受体和表皮生长因子受体2表达与乳腺癌伴微浸润临床病理变化

Association between clinicopathological features and the expression of estrogen receptor, progesterone receptor and human epidermal growth factor receptor 2 in ductal carcinoma in situ with micro-invasion

背景：雌激素受体和孕激素受体阳性表达为乳腺癌术后内分泌治疗提供重要依据，且表皮生长因子受体2过度表达己成为乳腺癌的独立预后因素。目的：探索乳腺浸润性导管癌伴微浸润中表皮生长因子受体2表达，并研究其与雌激素受体、孕激素受体关系及临床病理意义。方法：收集2008年2月至2014年4月病理诊断为乳腺浸润性导管癌伴微浸润患者267例，免疫组化法检测雌激素受体、孕激素受体及表皮生长因子受体2的表达，并分析其相互关系及与临床各因素的关系。结果与结论：乳腺浸润性导管癌伴微浸润患者中雌激素受体、孕激素受体及表皮生长因子受体2的阳性率分别为53．9％，53．5％和16．1％。其中患者雌激素受体阳性表达与孕激素受体阳性表达呈正相关（P〈0．05），而雌激素受体和孕激素受体表达一致率与表皮生长因子受体2表达呈负相关（P〈0．05）。另外雌激素受体、孕激素受体及表皮生长因子受体2三者的阳性表达率与患者年龄、肿瘤部位及大小、月经初潮年龄、临床分期无相关性（P〉0．05），但雌激素受体、孕激素受体表达与淋巴结转移程负相关性沪〈0．01），且C-erbB-2阳性表达与淋巴结转移正相关性（P〈0．01）。提示性激素在乳腺癌的发生发展中起着重要作用，联合检测雌激素受体、孕激素受体和表皮生长因子受体2对乳腺癌内分泌治疗及疗效预后评估有重要意义。

BACKGROUND： The positive expression of estrogen receptor （ER） or progesterone receptor （PR） provides evidence for endocrine therapy of breast carcinoma. The overexpression of human epidermal growth factor receptor 2 （HER2） is the independent predictive factor of poor prognosis in treatment of breast carcinoma. OBJECTIVE： To study the expression of HER2 in ductal carcinoma in situ with micro-invasion, explore the correlation with ER and PR, and identify clinical significance. METHODS： Information of 267 patients with ductal carcinoma in situ with micro-invasion were collected between February 2008 and April 2014 consecutively. The expression levels of ER, PR and HER2 were detected by immunohistochemistry method, and the relation between these three markers and other clinical features was analyzed. RESULTS AND CONCLUSION： The positive expression rate of ER, PR and HER2 was 53.9%, 53.5%, and 16.1% in patients with ductal carcinoma in situ with micro-invasion. The expression of ER was positively related with the expression of PR （P 〈 0.05）, the co-expression of ER and PR was negatively correlated with the expression of HER2 （P 〈 0.05）. The positive expression of ER, PR and HER2 had no relation with the age of patients, location or size of tumor, menarche age or clinical stage （P 〉 0.05）. However, the expression of ER and PR was negatively related with lymphatic metastasis （P 〈 0.01 ）, while the positive expression of C-erbB-2 was positively related with lymphatic metastasis （P 〈 0.01 ）. Sex hormones play an important role in the carcinogenesis and growth of breast cancer. The detection of ER, PR and HER2 is more meaningful for the endocrine therapy and prognosis of breast cancer.