HAS-2在乳腺癌中的表达及临床意义

Expression Level and Clinical Features of HAS-2 in Breast Cancer Patients

【目的】探讨透明质烷合酶2(HAS-2)在乳腺癌及癌旁组织中的表达差异及与其他临床病理指标的相关性,并分析其阳性表达与生存数据的关系。【方法】收集中山大学附属第三医院2000年6月至2003年6月间行乳腺癌手术的存档蜡块120例,病理证实为浸润性导管癌,设为实验组,对照组收集癌旁组织标本53例(距肿瘤>2 cm)。采用免疫组化法检测120例乳腺癌组织(实验组)及53例癌旁组织(对照组)中HAS-2的表达情况,比较两组HAS-2表达率的差异,以及实验组HAS-2的表达与其他临床病理指标的相关性。统计学分析采用SPSS20.0软件进行,计数资料比较采用卡方检验,生存分析采用Kaplan-Meier法,生存率比较采用Log-rank检验,同时采用COX比例风险回归模型进行多因素分析。【结果】乳腺癌组HAS-2的阳性表达率显著高于癌旁组织组(45.83%vs.20.75%,P=0.002)。实验组HAS-2表达水平与淋巴结转移(P<0.001)及Ki-67表达(P<0.001)呈密切相关性,与患者年龄、肿瘤大小、临床分期、组织学分级、ER、PR、Her-2表达等的差异无统计学意义。Kaplan-Meier法生存分析显示,HAS-2蛋白表达水平高的乳腺癌患者预后较低表达水平的患者差,差异有统计学意义(P=0.023)。Cox回归分析结果表明,淋巴结转移、TNM分期、Ki-67表达是判断乳腺癌患者预后的独立因素,而其他参数包括HAS-2并未达到统计学差异。【结论】HAS-2在乳腺癌组织中的表达水平较癌旁组织中明显升高,HAS-2在乳腺癌组织中的表达与淋巴结转移呈正相关,且与肿瘤增殖指标Ki-67呈正相关,HAS-2高表达的患者预后较差,表明其可能促进乳腺癌的发生发展,并预示着乳腺癌细胞增殖速度较快,预后欠佳。

【Objective】 To detect the expression of HAS-2 in breast cancer and adjacent paracancerous tissues, and analyze the correlation between its expression level and other clinical features of breast cancer. To evaluate its significance in prognosis.【Methods】 We enrolled 120 patients who were pathologically confirmed as invasive ductal carcinoma in the Third Affiliated Hospital of Sun Yat-sen between June 2000 to June 2003 as the experimental group and the control group collected 53 cases of adjacent normal tissues（the distance from the tumor 2 cm）. The expression of HAS-2 was detected by immunohistochemical method in 120 breast cancer patients（experimental group） and 53 adjacent paracancerous tissues（control group）.We compared the expression level between the two groups and analyze the relationship between HAS-2 expression and other clinical features.We used the Chi square test, Kaplan-Meier, Log-rank test and Cox＇s proportional hazards regression model to analyze the date we got. 【Results】 The expression of HAS-2 in breast cancer group was higher than adjacent paracancerous tissues group（45.83% vs.20.75%,P = 0.002）.HAS-2 expression level showed positive correlation with lymph node metastasis（P〈0.001）and the expression of Ki-67（P〈0.001）,but no statistical correlation with age, tumor size, clinical stage,histological grade,ER,PR and Her-2 expression. The Kaplan-Meier survival analysis method showed that compared with patients with low expression of HAS-2,patients with high HAS-2 expression level had significantly poor prognosis,and the difference had statistical significance（P = 0.023）.The Cox regression analysis showed that lymph node metastasis, TNM staging and Ki-67 expression were independent prognostic factors for breast cancer, while other parameters including HAS-2 did not have statistical differences. 【Conclusion】 The expression of HAS-2 is obviously increased in breast cancer patients than that in adjacent paracancerous tissues, and its expression was correlated with lymph node metastasis and expression of Ki-67. Patients with high HAS-2 expression level had significantly poor prognosis. These results may implicate that HAS-2 will promote the development of breast cancer and the higher expression of HAS-2 indicates the activated proliferation of cancer cell and poor survival rate.