ERβ和PTEN在人乳腺癌组织中的表达及其临床意义

Expressions of ERβ and PTEN in human breast cancer tissue and clinical significance

目的 探讨ERβ和PTEN在乳腺癌组织中的表达与临床病理特征及患者预后的关系。方法 回顾性收集2008—2009年在第三军医大学西南医院乳腺外科手术切除的110例乳腺癌组织标本,运用免疫组织化学方法检测组织标本中ERβ和PTEN的表达。采用χ2检验分析其表达与临床病理特征之间的关系,ERβ和PTEN相关性分析采用Spearman方法,运用Kaplan-Meier生存分析方法分析两者的表达与患者生存的关系。结果 ERβ在乳腺癌组织中阳性率为62.7%（69/110）,PTEN在乳腺癌组织中阳性率为59.1%（65/110）。ERβ和PTEN在乳腺癌组织中的表达呈正相关（r=0.276,P=0.003）。ERβ的表达与临床分期和淋巴结转移有关（χ2=11.766,P=0.003;χ2=9.919,P=0.007）。PTEN的表达也与与临床分期和淋巴结转移有关（χ2=9.014,P=0.011;χ2=12.201,P=0.002）。患者随访时间为8~70个月,中位随访时间为39个月。生存分析结果显示,ERβ阳性患者较阴性患者具有更好的5年DFS（χ2=7.707,P=0.005）。PTEN的表达也与较好的5年DFS有关（χ2=7.057,P=0.008）。笔者将ERβ和PTEN组合起来分为ERβ阳性PTEN阴性组（48例）、ERβ阴性PTEN阳性组（17例）、ERβ阳性PTEN阳性组（21例）以及ERβ阴性PTEN阴性组（24例）4个组进行生存分析,结果显示：组间差异有统计学意义（χ2=16.790,P〈0.001）,ERβ阴性PTEN阴性组患者5年DFS显著低于ERβ阴性PTEN阳性组、ERβ阳性PTEN阴性组、ERβ阳性PTEN阳性3个组（χ2=4.162,P=0.041;χ2=4.835,P=0.028;χ2=12.640,P〈0.001）。结论 ERβ和PTEN表达均阴性的乳腺癌患者预后较差,两者联合可以作为乳腺癌患者判断预后的分子标记。

Objective To evaluate the expressions of ERβ and PTEN in human breast cancer tissue, and their correlation with clinicopathologieal characteristics. Methods We retrospectively examined ERβ and PTEN expressions in breast cancer specimens from 110 patients treated in Department of Breast Surgery, Southwest Hospital, Third Military Medical University in 2008- 2009 by immunohistochemistry. χ2 test was used to analyze the relationship between the expressions of two factors and the clinieopathologieal characteristics, Spearman method was used to analyze the correlation between ERβ and PTEN, and Kaplan- Meier survival analysis was used to analyze the relationship between their expressions and patients＇ survival. Results The positive expression rate of ERβ was 62.7 % （69/110）and the positive expression rate of PTEN was 59. 1% （65/110）, indicating a positive correlation between ERβ and PTEN （r = 0. 276, P = 0. 003 ）. ERβ expression was associated with TNM stage （ ~2 = 11. 766, P = 0. 003 ） and lymph node metastasis （ χ2 = 9. 919, P=0. 007） ; PTEN expression was also correlated with TNM stage （~2 =9. 014,P=0. 011 ） and lymph node metastasis （X： =12. 201 ,P=0. 002）. The patients were followed up for 8-70 months, median 39 months. Survival analysis showed that ERβ positive patients exhibited a better 5-year DFS than those with ERβ negative did （ ~2 = 7. 707, P = 0. 005 ）, and PTEN positive patients had a better 5-year DFS compared with PTENnegative patients （ χ2 =7. 057, P = 0. 008 ）. There were 48 patients with ERβ positive and PTEN negative, 17 patients with ERβ negative and PTEN positive, 21 patients with ERβ positive and PTEN-positive and 24 patients with ERβ-negative and PTEN-negative. The above-mentioned 4 groups showed a significant difference in DFS （ χ2 = 16. 790, P 〈 0. 001 ）, DFS in patients with ERβ negative and PTEN negative was significantly lower than that in other 3 groups （χ2 = 4. 162, P = 0. 041 ;χ2 = 4. 835, P = 0. 028;χ2 = 12. 640, P〈 0. 001 ）. Conclusion The breast cancer patients with negative ERβ and PTEN expressions have a poor prognosis, so the two factors can be used as new molecular markers for evaluation of prognosis.