P57^(Kip2)和PCNA在乳癌中的表达及其与预后关系

EXPRESSION OF P57^(Kip2) AND PCNA IN PATIENTS WITH BREAST CARCINOMA AND ITS RELATION WITH THE PROGNOSIS

①目的 探讨有丝分裂抑制因子 (P5 7Kip2 )、增殖细胞核抗原 (PCNA)蛋白表达与乳癌预后的关系。②方法 以免疫组化S P法检测 138例乳癌组织P5 7Kip2 和PCNA蛋白的表达水平。③结果 在 138例乳癌组织中P5 7Kip2 蛋白阳性 5 5例 (39.86 % ) ,其中低表达 39例 (70 .91% ) ,高表达 16例 (2 9.0 9% )。PCNA低指数表达 6 3例 (45 .6 5 % ) ,PCNA高指数表达 75例 (5 4 .35 % )。P5 7Kip2 蛋白的表达与乳癌组织腺管形成、细胞核多形性、核分裂象计数和组织学分级呈负相关 (χ2 =5 .11～ 11.0 1,P <0 .0 1) ;单因素预后分析显示P5 7Kip2 蛋白高表达组生存期长于低表达组 (χ2 =6 .93,P <0 .0 1) ,PCNA高指数表达组生存期短于低指数表达组 (χ2 =5 .13,P <0 .0 5 ) ;P5 7Kip2 阳性并PCNA低指数表达组、P5 7Kip2 阳性并PCNA高指数表达组、P5 7Kip2 阴性并PCNA低指数表达组和P5 7Kip2 阴性并PCNA高指数表达组生存期依次缩短 (χ2 =7.32 ,P <0 .0 1)。④结论 P5 7Kip2 和PCNA的联合检测有利于更准确地判断细胞增殖活性和预后 ;P5 7Kip2 在乳癌中的不同表达水平可能与不同的调控方向有关。

Objective\ To study the expression of P57 Kip2 and PCNA in patients with breast carcinoma and its relation with the prognosis. \ Methods\ The expression of P57 Kip2 and PCNA was determined by S P immunohistochemical technique in 138 patients with breast carcinoma.\ Results\ Positive P57 Kip2 was detected in 55 cases(39.86%), of which low expression was 39 cases (70.91%), high expression 16 cases (29.09%). Of 138 PCNA positive cases, 63(45.65%) showed low index expression and 75(54.35%) with high index. The P57 Kip2 expression level was negatively correlated with tubule formation, nuclear atypia, mitosis and histological grade in breast cancer tissue( χ 2=5.11-11.01, P <0.01). An analysis demonstrated that the survival stage of patients with higher P57 Kip2 expression was longer than that of the lower expression ( χ 2=6.93, P <0.01). The survival stage of the group with high index expression of PCNA was shorter than that of the group with low index expression( χ 2=5.13, P < 0.05 ). The survival stage of the patients with P57 Kip2 +/PCNA low index, P57 Kip2 +/PCNA high index , P57 Kip2 -/PCNA low index and P57 Kip2 -/PCNA high index groups was shortened in sequence( χ 2=7.32, P <0.01). \ Conclusion\ Combined detection of P57 Kip2 /PCNA is helpful to judge the proliferating activity of the tumor cells and the patients prognosis. Different expression levels of P57 Kip2 in breast carcinoma is probably related with different regulating directions.