淋巴结转移阳性乳腺癌中Ezrin相关的上皮钙黏蛋白表达亚细胞定位的临床意义

Clinical Significance of Ezrin Associated Subcellular Localization of E-cadherin Expression in Lymph Nodes Positive Breast Cancer

目的探讨Ezrin与上皮钙黏蛋白（E-cad）表达部位的相关性及其对乳腺癌淋巴结转移等病理特征的影响。方法收集淋巴结转移阳性乳腺癌组织样本94例,采用免疫组化方法检测Ezrin和E-cad的表达情况。结果 E-cad和Ezrin阳性表达率分别为45.7%和58.5%;E-cad表达于细胞膜者（E-cadm）20例,表达于细胞质者（E-cadc）23例;与Ezrin阴性组织相比,Ezrin阳性组织中E-cadc表达频率显著增高（P=0.025）;在TNM分期较高（Ⅱ~Ⅲ）的组织中E-cad表达水平显著降低（P=0.001）;在较大的肿瘤组织中,Ezrin表达水平显著增高（P=0.036）,E-cadc表达频率显著高于E-cadm（P=0.013）;与E-cad（＋）、Ezrin（-）、E-cadm组织相比,E-cad（-）、Ezrin（＋）、E-cadc组织淋巴结转移数目显著增多（P〈0.05）;乳腺癌组织特征按照E-cad（＋）/Ezrin（-）、E-cad（-）/Ezrin（-）、E-cad（＋）/Ezrin（＋）、E-cad（-）/Ezrin（＋）的顺序（P〈0.001）,或者E-cadm/Ezrin（-）、E-cadc/Ezrin（-）、E-cadm/Ezrin（＋）、E-cadc/Ezrin（＋）的顺序（P=0.007）,淋巴结转移的数目均依次增多。结论在转移性乳腺癌中,Ezrin可能调节E-cad的亚细胞定位,从而协同影响乳腺癌病程,促进淋巴结转移。

Objective To investigate the relationship between Ezrin expression and subcellular localization of E-cadherin（E-cad）,and explore the clinical significance of this relationship to pathological features such as lymph nodes metastasis in breast cancer. Methods Ninety four cases of breast cancer tissue samples with lymph node metastasis were collected. The expression of Ezrin and E-cad was detected by immunohistochemical method. Results The positive rates of and E-cad and Ezrin were respectively 45.7% and 58.5% in 94 nodes positive breast cancer,containing membranal expression of E-cad（E-cadm）in 20 cases and cytoplasmic expression of E-cad（E-cadc）in 23 cases;the frequency of E-cadc positive staining was significantly higher in Ezrin（＋）tissues than that in Ezrin（-）tissues（P = 0.025）;E-cad expression level was significantly lower in TNM Ⅱ-Ⅲ stage cases（P = 0.001）,and Ezrin expression（P = 0.036）and E-cadc（P = 0.013）was significantly increased in bigger cases;compared with E-cad（＋）,Ezrin（-）,E-cadm tissues,the number of lymph node metastasis in E-cad（-）（P = 0.011）,Ezrin（＋）（P = 0.002）,E-cadc（P = 0.020）tissues were increased significantly;in the order of E-cad（＋）/Ezrin（-）,E-cad（-）/Ezrin（-）,E-cad（＋）/Ezrin（＋）,and E-cad（-）/Ezrin（＋）,the number of lymph node metastasis was increased significantly（P〈0.001）;similarly,in the order of E-cadm/Ezrin（-）,E-cadc/Ezrin（-）,E-cadm/Ezrin（＋）,and E-cadc/Ezrin（＋）,the number of lymph node metastasis was increased significantly（P = 0.007）. Conclusion Ezrin may regulate the subcellular localization of E-cad in metastatic breast cancer,which may affect the course of breast cancer and promote the metastasis of lymph nodes.