骨唾液酸蛋白表达和女性乳腺癌骨转移的关系

The relationship between the expression of bone sialoprotein and the bone metastasis in women with breast cancer

目的探讨骨唾液酸蛋白(BSP)在乳腺癌组织中表达和乳腺癌骨转移的关系。方法回顾性分析840例女性乳腺癌术后患者,根据治疗后随访是否有骨转移分为乳腺癌骨转移组和无骨转移组,用免疫组织化染色法测定840例原发性乳腺癌石蜡标本中BSP的表达,采用χ2检验和COX生存分析乳腺癌治疗后骨转移和生存的影响因素。结果 840例病例单因素分析显示:年龄、原发病灶大小、TNM临床分期、分子分型表达情况与乳腺癌术后骨转移的发生差异有统计学意义(P<0.05);BSP在骨转移组表达明显高于无骨转移组(无转移组+骨外转移组)(P<0.05);乳腺癌术后骨转移与淋巴是否转移、Cerb B-2情况、是否绝经、病理类型、细胞分级无关。多因素分析显示年龄越小、肿瘤体积越大、临床分期越晚、三阴性乳腺癌、BPS高表达是乳腺癌术后骨转移的危险因素。COX生存分析提示:乳腺癌组织标本中BSP高表达和低表达术后5年生存率差异有统计学意义(P<0.05)。结论初诊时临床分期、年龄、原发病灶大小、分子分型是乳腺癌术后发生骨转移的主要危险因素,BSP表达可能和乳腺癌术后骨转移及疾病进展相关。

Objective To investigate the relationship between the expression of bone sialoprotein （BSP） and the bone metastasis of breast cancer. Methods 840 cases of female breast cancer patients were retrospectively ana- lyzed. The patients were divided into breast cancer bone metastasis group and no bone metastasis group according to whether the patients had bone metastasis after treatment, BSP expression in paraffin specimens of 840 cases of pri- mary breastcancer was determined by immunohistochemical method, X2 test and COX survival analysis was used in analysis of influencing factors of bone metastasis and 5 years survival after treatment of breast cancer. Results 840 cases of breast cancer postoperatively of single factor analysis showed that age, primary tumor size, clinical stage, TNM and molecular typing were statistically significant（P 〈0. 05 ）. BSP in bonemetastasis group was significantlyhigher than that in patients without bone metastasis（ non metastasis group and bone metastasis group） （ P 〈 O. 05 ） However, CerbB-2, lymph node metastasis, whether menopause, pathological type, cell grading showed no correla- tion. Multivariate analysis revealed that age, tumor volume, clinicalstage, three negative breast and high expression of BPS were risk factors for bone metastasis. COX survival analysis of breast cancer 5 year survival rate, BSP high expression group and low expression group was statistically significant （P 〈~ O. 05 ）. Conclusion The clinical stage, age, primary lesion size and molecular type are the main risk factors for bone metastasis after breast cancer treat- ment. Bone sialoprotein expression is closely related to breast cancer bone metastasis.