Claudin-low型乳腺癌的临床病理及预后特征

Clinicopathologic and prognosis features of Claudin-low breast cancers

目的 探讨Claudin-low型乳腺癌患者的临床病理及预后特征.方法 收集2010年1月至2011年12月青岛市中心医院233例浸润性乳腺癌患者病例及随访资料,采用组织芯片及免疫组织化学法检测Claudin-1、-3、-4、-7、-8的表达情况,并分析浸润性乳腺癌患者Claudin蛋白表达情况、Claudin-low型乳腺癌患者的临床病理及预后特征.结果 Claudin蛋白表达以Claudin-3（72/212,33.9%）和Claudin-4（56/212,45.2%）的表达率最相近,Claudin-4的表达量最高.21例Claudin-low型乳腺癌（21/212,9.0%）中,11例为三阴性乳腺癌（11/21,52.4%）,组织学类型以非特殊型浸润性癌（14/21,66.7%）和化生性癌（3/21,14.3%）为主,其中化生性鳞状细胞癌不呈现Claudin-low型表达.与非Claudin-low型乳腺癌相比,Claudin-low型乳腺癌组织学3级及肿瘤直径〉2 cm的比例较高,仅略低于三阴性乳腺癌.5年无病生存率（P〉0.05）和总生存率（P=0.018）均低于非Claudin-low型乳腺癌.结论 Claudin-low型乳腺癌在临床病理及预后特征与其他各型乳腺癌存在不同之处,与差的预后相关.

Objective To investigate the clinicopathologic and prognostic features of Claudin-low breast cancers （CLBC）.Methods Tissue microarray sections were scored semiquantitatively for the immunohistochemical expression of claudin-1,-3,-4,-7 and-8 in 233 cases of invasive breast cancers collected from Qingdao Central Hospital from January 2010 to December 2011.Results The expression rate of Claudin-3 （72/212,33.9%） and-4 （56/212,45.2%） was most similar, and Claudin-4 showed the highest expression.Twenty one cases （21/212,9.0%） were diagnosed as CLBC, with triple-negative breast cancer （TNBC） accounted for the highest proportion （11/21,52.4%）.Among the CLBC cases, the invasive carcinoma no special type （66.7%,14/21） and metaplastic carcinoma （14.3%,3/21） were mostly seen, while metaplastic squamous carcinoma did not show Claudin-low pattern.Compared to the non CLBC in this cohort, CLBC had higher proportion of histologic grade 3 and tumors larger than 2 cm, and the proportions were slightly lower than TNBC.Patients with CLBC had lower 5 year disease-free（P〉0.05） and overall survival rates（P=0.018）.Conclusion CLBC shows distinct clinicopathologic and prognostic features comparing to other subtypes, and is associated with poor prognosis.