乳球蛋白在乳腺非特殊型浸润性癌中的表达及临床意义

Mammaglobin Protein Expression and the Clinical Significance in Patients with Invasive Breast Cancer of Non-specific Type

目的探讨乳球蛋白(mammagblobin,MAG)在乳腺非特殊型浸润性癌组织中的表达,及其与乳腺非特殊型浸润性癌临床病理特征的关系。方法收集200例临床病理资料完整的乳腺非特殊型浸润性癌病例,及此200例的癌旁正常乳腺组织作为对照,同时对此组病例中癌灶周围的112例导管原位癌及108例导管上皮普通型增生进行相关检测分析,采用免疫组化SP二步法检测MAG、ER、PR、HER2、GST、P170、TOPOⅡ和EGFR的表达情况,以阳性细胞百分比和着色强度得分相乘将MAG的表达分为低表达(<5分)和高表达(>5分),分析MAG表达与患者年龄、癌灶体积、腋窝淋巴结转移情况和病理组织学分级等的关系,以及其与ER、PR、HER2、GST、P170、TOPOⅡ和EGFR表达的关系。结果 MAG在癌旁正常乳腺导管上皮、癌旁乳腺导管上皮普通型增生、乳腺导管原位癌及非特殊型浸润性癌中的阳性率分别为14%、100%、92.86%和66%,差异具有统计学意义(P<0.05)。MAG在低分化浸润性癌中的阳性表达率(32.93%)高于其在高分化(13.51%)和中分化(0%)者(P<0.05)。在癌灶>2cm的癌细胞中MAG的阳性表达率为82.89%,高于≤2cm者(55.65%,P<0.05)。MAG高表达率在PR(21.85%)、HER2(18.71%)、TOPOⅡ(18.18%)阳性的癌细胞中均分别高于PR(7.41%)、HER2(0%)、TOPOⅡ(0%)阴性者(P<0.05);其在P170阳性的癌细胞中高表达率为8.43%,低于P170阴性者的21.37%(P<0.05)。结论 MAG参与了乳腺非特殊型浸润性癌的发生发展过程,对癌细胞的增殖、分化有一定促进作用,可能参与了PR、HER2、TOPOⅡ和P170在乳腺非特殊型浸润性癌中的分子作用机制。

Objective To investigate the protein expression of mammaglobin（MAG）in invasive breast carcinoma of non-specific Type（IBC-NST）,and to analyze the relationship between MAG with clinical pathological features and treatment-related factors.MethodsThe clinicopathological data of 200 cases of IBC-NST were obtained from Cancer Hospital affiliated to General Hospital of Ningxia Medical University. 200 cases of normal tissue,112 cases of ductal carcinoma in situ（DCIS）and 108 cases of ductal hyperplasia were also investigated. The immunohistochemistry method was used to detect the protein expressions of ER,PR,HER2,GST,P170, TOPOⅡand EGFR in IBC-NST. The total score was the product of multiplying positive percentage by staining grades,and the total score was divided into low expression group（〈5）and high expression group（〉5）. The relationships between MAG expression with age,the size of caicinoma,the metastasis of axillary lymph nodes, and pathological grades of IBC-NST were analyzed.ResultsThere was significant difference of MAG expression between normal（14%）,usual ductal hyperplasia（100%）,DCIS,（92.86%）and IBC-NST（66%）. MAG high expression was significantly increased in low-differentiation group（32.93%）than those in high-（13.51%）and middle-（0%）differentiation groups（P〈0.05）. MAG expression was obviously higher in IBC-NST with the diameter 〉 2 cm（82.89%）compared with the diameter≤2cm（55.65%,P〈0.05）. Furthermore, the positive rate of MAG high expression was respectively significantly increased in PR（21.85%）,HER2 （18.71%）and TOPOⅡ（18.18%）positive cancer cells than that in PR（7.41%）,HER2（0%）and TOPOⅡ（0%）negative cancer cells（P〈0.05）. However,its positive rate of high expression was 8.43% in P170 positive cancer cells,which was significantly lower than it in P170 negative cancer cells（21.37%,P〈0.05）and P170 in IBC-NST.ConclusionMAG may affect the tumorigenesis and the progression of IBC-NST,promote the proliferation and differentiation of cancer cells,and participate in the molecular mechanism of PR,HER2, TOPOⅡand P170,thus,correlate with the treatment of IBC-NST.