ICAM-1在三阴性乳腺癌中的表达的临床意义及与预后的关系

Clinical significance of ICAM-1 expression and its correlation with prognosis of triple-negative breast cancer

背景与目的:三阴性乳腺癌(triple-negative breast cancer,TNBC)侵袭性强,预后差,治疗手段匮乏。该研究通过检测人TNBC与对应癌旁组织中细胞间黏附分子-1(intercellular adhesion molecule-1,ICAM-1)蛋白的表达,研究ICAM-1蛋白与TNBC临床病理特征及预后的相关性。方法:收集59例TNBC及其对应的50例癌旁组织标本,应用免疫组织化学法检测ICAM-1在59例TNBC及50例癌旁组织中的表达水平,比较其阳性率。分析ICAM-1蛋白的表达与TNBC年龄、肿瘤大小、临床病理类型、组织学分级、淋巴结转移、肿瘤TNM分期、脉管癌栓、神经浸润、Ki-67、p53和E-cadherin等临床病理特征及与患者预后的关系。结果:TNBC中ICAM-1的表达明显高于癌旁组织(P=0.000)。ICAM-1与淋巴转移、组织学分级和TNM分期有关(P分别为0.036、0.027和0.048),与肿瘤大小、临床病理类型、脉管癌栓、Ki-67水平、p53和E-cadherin表达等无关。ICAM-1高表达组患者的无病生存时间(disease-free survival,DFS)显著较ICAM-1低表达组短(P=0.036),但对于总生存时间(overall survival,OS)没有显著影响。另外,Cox比例风险模型多因素分析,ICAM-1表达、淋巴结转移是影响DFS的独立危险因素(HR=3.2,95%CI:1.6-6.4,HR=2.7,95%CI:1.3-5.9,P均<0.05)。结论:ICAM-1蛋白可以作为判断TNBC恶性程度的指标,ICAM-1高表达的三阴性乳腺癌临床预后差。

Background and purpose： Triple negative breast cancer （TNBC） is with high invasion, poor prognosis and lack of usefull treatment. This study investigated expression status of ICAM-1 protein in TNBC in order to explore its relationship with clinicopathological features and outcome in patients. Methods： Fifty-nine tissue samples of TNBC were collected while 50 cases of para-carcinoma tissue samples were used as negative controls. Immunohistochemical staining was conducted to detect expression level of ICAM-1 protein. The relationship of ICAM- 1 protein expression with clinicopathological features （age, tumor size, subtype, grade, status of lymph node metastasis, TNM stage, vascular tumor thrombus, nerve infiltration, Ki-67, p53 and E-cadherin expression） and outcome in patients were analyzed. Results： The ICAM-1 protein expression of TNBC was significantly higher than that in adjacent tissues （P=0.000）. ICAM-1 expression was related to status of lymph node metastasis, grade and TNM stage （with a P-value of 0.036, 0.027 and 0.048, respectively）, while demonstrated an undefined relationship with tumor size, subtype, vascular tumor thrombus and expression of Ki-67, p53 and E-cadherin. The disease-free survival （DFS） of ICAM-1 high expression set was shorter than that of the lower one but has nothing to do with overall survival （OS）. In addition, Cox proportional hazards model showed that ICAM-1 expression and lymph node metastasis were independent risk factors of DFS in patients （HR=3.2, 95%CI： 1.6 to 6.4, HR=2.7, 95%CI： 1.28 to 5.9, P〈0.05）. Conclusion： ICAM-1 could serve as a predictive factor for differentiation status of TNBC. The high expression of ICAM-1 in TNBC may indicate poorer prognosis.