乳腺导管原位癌钙化特征与ER、PR、HER2的关系

Relationships of ductal carcinoma in situ calcification feature and ER, PR and HER2 expression

目的 探讨乳腺导管原位癌钙化特征与雌激素受体（ER）、孕激素受体（PR）、人表皮生长因子受体2（HER2）表达的关系.方法 回顾性分析2013年1月至2016年12月在我院确诊的乳腺导管原位癌患者226例的乳腺钼靶X线检查结果,依据钙化特征分为钙化组（n=110）和无钙组（n=116）.免疫组织化学法检测ER、PR、HER2的表达情况,分析其与钙化特征的关系.结果 钙化组患者ER、PR阳性表达率为72.73％和54.55％,明显高于无钙组的39.66％和38.79％（x2=25.033,P＜0.001x2=5.632,P=0.036）;钙化组患者HER2阳性表达率为45.45％,明显低于无钙组的82.76％（x2=34.358,P＜0.001）.单因素分析显示,钙化形态（x2=31.098,P＜0.001;x2=24.117,P=0.003）、分布（x2=30.272,P＜0.001;x2 =11.811,P=0.008）、数目（x2=15.533,P＜0.001;x2=7.875,P=0.019）、伴发情况（x2=27.915,P＜0.001;x2=7.229,P=0.027）均与ER、PR的表达有关;钙化分布（x2=8.068,P=0.035）、数目（2=60.768,P＜0.001）、伴发情况（x2=24.915,P＜0.001）与HER2的表达有关;Logistic回归分析显示,形态细小多形、簇状分布、数目＞30个、伴肿块是ER、PR、HER2表达的独立影响因素（均P ＜0.001）.结论 导管原位癌的乳腺钼靶片钙化特征与ER、PR、HER2表达有关,形态细小多形、簇状分布、数目＞ 30个、伴肿块可作为初步预测其生物学治疗和预后因子表达的重要参考指标.

Objective To discuss the relationships of ductal carcinoma in situ calcification feature and estrogen receptor （ER）,progesterone receptor （PR）,human epidermal growth factor receptor 2 （HER2） expression.Methods The mammary gland molybdenum target X-ray results of 226 patients with ductal carcinoma in situ were retrospectively analyzed in our hospital during January 2013 to December 2016.All patients were divided into calcification group （n =110） and no calcium group （n =116）.Immunohistochemical method was used to detect the expressions of ER,PR and HER2,and their relationships with calcification feature were analyzed.Results The positive expression rates of ER and PR in calcification group were 72.73% and 54.55% significantly higher than those in no calcium group （39.66% and 38.79%;x2=25.033,P 〈0.001;x2 =5.632,P =0.036）.The positive expression rate of HER2 in calcification group was 45.45%,significantly lower than that of the no calcium group （82.76%,x2 =34.358,P 〈 0.001）.According to the single factor analysis,the calcified form （x2 =31.098,P 〈 0.001;x2 =24.117,P =0.003）,distribution （x2=30.272 P〈0.001;x2=11.811,P=0.008）,number （x2 =15.533 P〈0.001;x2 =7.875,P=0.019） and concomitant situation （x2 =27.915,P 〈0.001;x2 =7.229,P =0.027） were associated with ER and PR expressions,and the calcified distribution （x2 =8.068,P =0.035）,number （x2 =60.768,P 〈0.001） and concomitant situation （x2 =24.915,P 〈 0.001） were associated with HER2 expression.Logistic regression analysis shows that the small polymorphic form,cluster distribution,number 〉 30,with mass were the independent prediction factors of ER,PR and HER2 expressions （all P 〈 0.001）.Conclusion The mammary gland molybdenum target calcification features of ductal carcinoma in situ are associated with ER,PR and HER2 expressions,the small polymorphic form,cluster distribution,number 〉 30,with mass can be used as important reference indexes to preliminarily predict biological therapy and expressions of prognostic factors.