三阴与非三阴性乳腺癌患者肿瘤标志物及Ki-67的表达

Expressions of tumor markers and Ki-67 in triple-negative and non-triple-negative breast cancer

目的探讨三阴性乳腺癌(TNBC)与非TNBC患者肿瘤标志物及Ki-67的表达。方法选择2016年8月至2017年5月山东大学附属省立医院经病理检查确诊的女性乳腺癌患者184例,其中TNBC组32例,非TNBC组152例,另选择同期收治女性乳腺良性肿瘤疾病患者41例(乳腺良性肿瘤组),采用化学发光法检测3组患者肿瘤标志物癌胚抗原、糖类抗原125、糖类抗原153,采用免疫组织化学法检测2组乳腺癌患者手术切除病理组织Ki-67的表达,比较2组乳腺癌患者临床病理特征及与Ki-67阳性指数的关系。结果 TNBC组糖类抗原125、糖类抗原153水平高于非TNBC组和乳腺良性肿瘤组,且非TNBC组高于乳腺良性肿瘤组,差异均有统计学意义(均P<0.05);TNBC组、非TNBC组癌胚抗原表达水平高于乳腺良性肿瘤组,差异均有统计学意义(均P<0.05),但TNBC组与非TNBC组比较差异无统计学意义(P>0.05)。TNBC组肿瘤长径≤2 cm 7例、>2 cm 25例,有淋巴结转移22例(68.8%);非TNBC组肿瘤长径≤2 cm66例、>2 cm 86例,有淋巴结转移72例(47.4%)。2组患者间肿瘤长径和淋巴结转移率比较差异均有统计学意义(均P<0.05),年龄和组织学分级比较差异均无统计学意义(均P>0.05)。TNBC组Ki-67阳性指数明显高于非TNBC组[40%(20%,42%)比20%(15%,30%)],差异有统计学意义(P<0.05)。2组不同年龄、肿瘤长径、淋巴结转移情况和组织学分级乳腺癌患者的Ki-67阳性指数比较差异均无统计学意义(均P>0.05)。结论 TNBC患者Ki-67阳性指数较高,淋巴结转移比例和肿瘤长径>2cm比例较高,同时癌胚抗原、糖类抗原125、糖类抗原153也是TNBC治疗及预后判断的重要辅助诊断指标。

Objective To investigate the expressions of tumor markers and Ki-67 in triple-negative breast cancer（TNBC） and non-TNBC.Methods From August 2016 to May 2017,clinical records of 184 patients with breast cancer（32 TNBC and 152 non-TNBC） and 41 patients with benign breast disease in Shandong Provincial Hospital Affiliated to Shandong University were collected.Carcinoembryonic antigen （CEA）,carbohydrate antigen 125 （CA125） and CA153 were detected by chemiluminescence.Ki-67 was detected by immunohistochemistry.The relation between clinicopathological features of breast cancer and Ki-67 expression was analyzed.Results Levels of CA125 and CA153 in TNBC were significantly higher than those in non-TNBC and benign breast disease（P 〈0.05）.CEA level in TNBC and non-TNBC was significantly higher than that in benign breast disease（P 〈 0.05）,but there was no significant difference between TNBC and non-TNBC （P 〉 0.05）.In TNBC,tumor diameter was ≤2 cm in 7 cases and 〉2 cm in 25 cases;22 patients（68.8%） had lymphatic metastasis.In non-TNBC,there were 66 cases of tumor diameter≤2 cm and 86 cases of tumor diameter 〉2 cm;72 patients（47.4%） had lymphatic metastasis.Tumor diameter,lymphatic metastasis,age and histological grade showed no significant difference between TNBC and non-TNBC （P 〉 0.05）.Expression of Ki-67 in TNBC was higher than that in non-TNBC [40% （20%,42%） vs 20% （15%,30%）] （P 〈 0.05）.Expression of Ki-67 showed no significant difference among breast cancer patients with different age,tumor diameter,lymphatic metastasis and histological grade （P 〈 0.05）.Conclusion TNBC patients have high expression of Ki-67,high rate of lymph node metastasis and large tumor size;CEA,CA153 and CA125 are important diagnostic indicators of TNBC.