细胞核增殖抗原和p53与乳腺浸润性导管癌Her-2基因表达的关系

The association between the expression of Ki-67,p53 and Her-2 in breast invasive ductal carcinoma

目的分析细胞核增殖抗原(Ki-67)、p53在乳腺浸润性导管癌(IDC)中的表达情况及其临床病理表现特点,并探讨Ki-67、p53与Her-2表达之间的关系。方法回顾性分析228例乳腺IDC患者的临床资料,其中Her-2阳性88例,Her-2阴性140例,免疫组织化学法检测所有乳腺IDC标本中Ki-67及p53的表达情况,分析Ki-67和p53的表达与乳腺癌的临床病理特点及Her-2表达之间的相关性。结果 Ki-67高表达与肿瘤大小、淋巴结转移、肿瘤分期及脉管癌栓均差异无统计学意义(P>0.05),而在激素受体阴性、绝经前、肿瘤分级髙及Her-2阳性患者中Ki-67高表达率明显增高(P<0.05);p53阳性与月经状态、肿块大小、淋巴结转移、肿瘤分期及脉管癌栓均差异无统计学意义(P>0.05),而在激素受体阴性及Her-2阳性患者中p53阴性率明显增高(P<0.05);Her-2阳性乳腺IDC中,p53阳性表达率为58.0%,Ki-67高表达率为88.6%,Her-2阴性组中p53及Ki-67高表达率分别为40.7%和51.4%,两者相比差异均有统计学意义(P<0.05),但Ki-67髙表达在p53阳性与阴性患者中差异无统计学意义(P<0.05)。结论 Ki-67和p53在Her-2阳性乳腺IDC中均表达升高,提示可以作为乳腺癌预后不良因素。

Objective To investigate the expression of Ki-67 and p53 in breast invasive ductal carcinoma （IDC） and the association between the human epidermal growth factor receptor 2 （Her-2） expression. Methods A to- tal of 228 breast IDC patients were retrospectively collected and analyzed.. The expression of p53 and Ki-67 were detec- ted by streptavidin-peroxidase （SP） immunohistochemistry assay. The association between expression of 1053, Ki-67 and Her-2 were analyzed. Results Ki-67 expression was statistically correlated with menopausal status and pathology grade （P 〈 0.05 ）, but there was no statistically significant difference in tumor size, clinical stages and lymph node metastasis （ P 〉 O. 05 ）. There was no significant correlation between 1353 expression with menopausal status, pathology grade, tumor size and lymph node metastasis （ P 〉 0.05 ）. The expression of Ki-67 and p53 were negatively correlated with estrogen receptor （ER） （ P = O. 00） and progesterone receptor （PR） （ P = O. 00）, and positively correlated with Her-2 overex- pression （ P = 0.00）. The positive expression rates of p53 and Ki-67 in breast IDC patients with Her-2 positive were significantly higher than those in patients with Her-2 negative （ P 〈 0.05 ）. However, there was no correlation between the expression of Ki-67 and p53 （P 〉 O. 05）. Conclusion Ki-67 and p53 could be used as prognostic factors in breast IDC,which may play a synergetic role in the carcinogenesis and progression of breast IDC.