乳腺癌患者HER-2、PCNA和E-cadherin蛋白表达及临床病理特征与预后的相关性

Relationship between expression of HER-2,PCNA,E-cadherin and clinical pathological parameters and prognosis in breast carcinoma

目的:探讨乳腺癌组织中HER-2、PCNA和E-cadherin蛋白表达,分析它们与乳腺癌临床病理特征的关系,并探讨三者及临床病理特征与乳腺癌预后的关系。方法:应用SP免疫组化方法检测70例浸润性乳腺癌组织和10例乳腺纤维腺瘤病变中HER-2、PCNA和E-cadherin蛋白的表达。结果:HER-2、PCNA和E-cadherin在乳腺癌组织中的高表达率分别为58.57%、64.29%、40.00%,与乳腺纤维腺瘤组相比差异均有统计学意义(P<0.01)。乳腺癌组织中三者的表达均与临床TNM分期、组织学分级、淋巴结转移数目密切相关(P<0.05),另外,HER-2的表达与雌激素受体(ER),E-cadherin的表达与肿瘤大小亦密切相关(P<0.05)。Kaplan-Meier生存曲线分析显示随着HER-2、PCNA蛋白表达的增多、淋巴结转移数目的增加及临床分期级别的增高,患者的生存率均明显下降(P<0.01)。多因素Cox回归分析表明,HER-2和临床TNM分期均为乳腺癌患者独立的远期预后指标(P<0.05)。结论:乳腺癌中HER-2和PCNA的过表达,及Ecadherin表达的缺失与肿瘤的发生发展、增殖、侵袭转移及预后密切相关。联合检测HER-2、PCNA和Ecadherin有助于筛选出具有高复发及转移危险的患者,从而指导临床治疗。

Objective： To discuss the expression of HER-2,PCNA and E-cadherin and the relationship with clinical pathological parameters in breast carcinoma and their correlation with prognosis. Methods： With SP immunohistochemistry,the expression of HER-2,PCNA and E-cadherin was evaluated in 70 samples with invasive breast carcinoma,and 10 samples with breast fibroadenoma. Results： The high expression rates of HER-2,PCNA and E-cadherin in breast carcinoma were 58. 57%,64. 29% and 40. 00% respectively,which were significantly different with that in breast fibroadenoma（ P〈0.01）. The expression of both of them in breast carcinoma had close correlation with the clinical TNM stage,histological grade,lymph node metastasis（ P〈0.05）,but the expression of HER-2 also had close correlation with ER（ P〈0.05）,and the expression of E-cadherin also had close correlation with tumor size（ P〈0.05）. Kaplan-Meier survival curve showed that patients with higher expression of HER-2 and PCNA,more number of lymph node metastasis and higher clinical TNM stage were worse than the corresponding ones,with significant differences（ P〈0.01）. Cox multivariate regression analysis showed that HER-2 and clinical TNM stage both could be independent prognostic indicators in breast carcinoma（ P〈0.05）. Conclusion： The up-regulated expression of HER-2 and PCNA as well as deletion of E-cadherin are involved in progression,metastasis and invasion of breast carcinoma and indicate poor prognosis. Combined detection of HER-2,PCNA and E-cadherin would be helpful in screening the patients with high risks of recurrence and metastasis,thus can be good for further treatment.