ERα、TWIST与乳腺癌的相关性分析及对预后的影响

Correlation analysis of ERα,TWIST and breast cancer and its effect on prognosis

目的探讨雌激素受体α(ERα)、扭曲基因(TWIST)在乳腺癌中的表达及临床意义。方法回顾性选取2012年9月至2017年10月保存的89例乳腺癌石蜡标本,同时选取癌旁组织(距肿瘤边缘>3 cm)作为对照。采用免疫组织化学法检测TWIST和ERα表达,比较乳腺癌组织和癌旁组织中的TWIST、ERα表达,分析乳腺癌中TWIST、ERα表达与临床病理特征关系;观察TWIST、ERα与微血管密度(MVD)的关系。分析TWIST、ERα与患者预后的关系,以及TWIST和ERα的相关性。结果乳腺癌组织TWIST阳性表达率为78.65%,明显高于癌旁组织(P<0.05),而ERα阳性表达率为30.34%,明显低于癌旁组织(P<0.05);中低分化、有淋巴结转移患者TWIST阳性表达率分别为93.75%和94.74%,明显高于高分化、无淋巴结转移转移患者(P<0.05),而ERα阳性表达率分别为8.33%和5.26%,明显低于高分化、无淋巴结转移患者(P<0.05);TWIST表达阳性患者MVD为(34.16±6.84),明显高于TWIST表达阴性者(P<0.05);ERα表达阳性和阴性患者MVD比较差异无统计学意义(P>0.05);TWIST阴性患者中位无进展生存时间和总生存时间分别为42.81个月和66.73个月,明显长于TWIST阳性患者(P<0.05);ERα阳性患者中位无进展生存时间和总生存时间分别为42.81个月和57.85个月,明显长于ERα阴性患者(P<0.05);TWIST和ERα在乳腺癌组织中表达呈负相关关系(r_s=-0.611,P<0.05)。结论乳腺癌组织中TWIST呈高表达,而ERα呈低表达,与患者临床病理特征和预后有一定联系,值得进一步研究。

Objective To investigate the expression of estrogen receptor α（ ERα）,twist gene（ TWIST） in breast cancer and its clinical significance. Methods 89 cases of breast cancer paraffin specimens preserved in our hospital from September 2012 to October 2017 were selected,and the adjacent tissues of the tumor（ from the margin of tumor 3 cm） were selected as the control. The expressions of TWIST and ERαwere detected by immunohistochemistry. The expressions of TWIST and ERα in breast cancer tissues and paracancerous tissues were compared.The expression of TWIST and ERα in breast cancer was analyzed with clinicopathological features. The relationship of the expression of TWIST,ERα and microvessel Density（ MVD） were discussed. To analyze the relationship between TWIST,ERα and patient＇s prognosis,as well as the correlation between TWIST and ERα. Results TWIST positive expression rate of the breast cancer tissue was 78. 65%,significantly higher than those in adjacent tissues（ P〈0. 05）,while the ERα positive expression rate was 30. 34 %,significantly lower than that in the adjacent tissues（ P〈0. 05）. In middle and low differentiation,lymph node metastasis patients,TWIST positive expression rates were 93. 75% and 94. 74%,significantly higher than that in high differentiation,without lymph node metastases（ P〈0. 05）,while the ERα positive expression rates were8. 33 % and 5. 26 %,significantly lower than that of high differentiation,without lymph node metastasis patients（ P〈0. 05）. The MVD in patients TWIST positive expression was（ 34. 16 ± 6. 84）,significantly higher than that of TWIST negative expression（ P〈0. 05）. The difference of MVD in patients with ERα positive and negative expression was not statistically significant（ P〈0. 05）. The median progression free survival and overall survival in TWIST negative patients were 42. 81 months and 66. 73 months,which were significantly longer than those of TWIST positive patients（ P〈0. 05）. The median progression free survival and overall survival of ERα positive patients were 42. 81 months and 57. 85 months,significantly longer than the ERα negative patients（ P〈0. 05）. TWIST and ERα expression in breast cancer was negatively correlated（ r_s=-0. 611,P〈0. 05）. Conclusion TWIST is highly expressed in breast cancer tissues,while ERα is low expression,which is related to the clinicopathological features and prognosis of patients with breast cancer,and deserves further study.