乳腺浸润性导管癌X线表现与ER、PR、Her-2、Ki-67、P53表达的相关性研究

Correlation of mammographic signs to the expressions of ER,PR,Her-2,Ki-67 and P53 in invasive duct carcinoma of breast

目的探讨乳腺浸润性导管癌X线表现与免疫组化指标雌激素受体(ER)、孕激素受体(PR)、人表皮生长因子受体-2(Her-2)、Ki-67、P53表达水平间相关性,并探讨其临床意义。方法回顾性分析已确诊的浸润性导管癌220例,观察其钼靶X线影像特征及经免疫组织化学染色测定乳腺肿瘤细胞的ER、PR、Her-2、Ki-67、P53表达情况。采用Spearman相关分析进行统计学分析。结果 220例乳腺浸润性导管癌中,表现为肿块者162例(73.6%),肿块中出现毛刺征者95例(58.6%),有钙化者98例(44.5%),局限性密度增高者32例(14.5%),腺体结构扭曲者26例(11.8%)。乳腺癌钙化与Her-2阳性表达明显正相关(r=0.241,P<0.001);乳腺癌毛刺征与ER阳性表达呈正相关性(P<0.05),与Ki-67、P53阳性表达间呈负相关性(P<0.05);乳腺癌伴发皮肤增厚及皮肤、乳头凹陷者与ER、PR阳性表达呈正相关(P<0.05)。结论乳腺浸润性导管癌钼靶X线表现与免疫组化指标ER、PR、Her-2、Ki-67、P53表达水平有一定的相关性。通过乳腺癌的X线影像表现可以一定程度上预估ER、PR、Her-2、Ki-67、P53的表达水平,从而可以前瞻性地评估乳腺癌细胞的生物学行为及预后,更好地为临床治疗及病情评估提供客观依据。

Objective To study the correlation of mammographic Her - 2,Ki - 67 and P53 in infiltrating ductal carcinoma of breast （IDC）. signs to the expressions of ER, PR （estrogen/progeslerone recepter）, Methods Pre - operative mammography was performed in all the 220 cases of patients with pathologically - proved IDC of breast. The specimens of mastectomy of the IDC were stained with immunohistochemistry and the expressions of ER,PR,Her - 2,Ki - 67 and P53 were measured. Results On the mammograms of the 220 cases, masses were shown in 162 cases （73.6%）, spicule sign in 95 cases （58.6%）, calicifications in 98 cases（44.5% ） ,focal asymmetry in 32 cases （ 14.5% ）, and breast ar- chitecture distortion in 26 cases （ 11.8 % ）. The calcification of infiltrating duct carcinoma of breast was positively correlated with Her - 2 positive expression （ r = 0. 241, P 〈 0. 001 ）. The spiculated sign of infiltrating duct carcinoma of breast was positively correlated with ER positive expression （ P 〈 0.05） and was negatively correlated with Ki - 67 and P53 positive expression （ P 〈 0.05）. The nipple adherence and skin incrassation of infihrating duct carcinoma of breast was positively correlated with ER and PR positive expression P 〈 0.05 ）. Conclusion The molybdenum target mammographic features of IDC were closely correlated to the expressions of ER, PR, Her - 2, Ki - 67 and P53. These features were in a considerable extent prospective reflecting the biological behaviors of tumor cells and prognosis of cases. Therefore, molybdenum target mammo- graphic features had potential clinical advantages in the assessment, treatment and prognosis of breast cancer.