三阴乳腺癌临床病理和生物学特征及预后因素研究

CLINICOPATHOLOGIC AND BIOLOGICAL FEATURES OF TRIPE NEGATIVE BREAST CANCER AND THEIR PROGNOSTIC SIGNIFICANCE

目的:利用免疫组化的实验方法探索三阴型乳腺癌的病理特征及预后,检测表皮生长因子受体(Epidermal growth factor receptor,EGFR)、上皮性钙黏附蛋白(E-cadherin)、雄激素受体(Androgen receptor,AR)分别在三阴乳腺癌和非三阴乳腺癌中的表达,分析其临床意义。方法:选取三阴乳腺癌(Three negative breast cancer,TNBC)和非三阴乳腺癌(non-Three negative breast cancer,non-TNBC)各50例,免疫组化方法检测表皮生长因子受体(EGFR)、上皮性钙黏附蛋白(E-cadherin)、雄激素受体(AR)的表达情况,分析它们各自表达意义,与临床因素和预后的关系。结果:(1)EGFR在100例乳腺癌中阳性率为48%(48/100),E-eadherin异常表达率和AR阳性率分别为53%(53/100)、65%(65/100)。(2)E-cadherin正常表达组和AR阳性组的5 a DFS分别高于Ecadherin异常表达组和AR阴性组(P<0.05),差别有统计学意义。(3)EGFR、E-cadherin、AR在TNBC和nonNBC中的表达情况:TNBC中EGFR阳性率和E-cadherin异常表达率高于non-TNBC,AR阳性率低于non-TNBC(P<0.05),差别有统计学意义。(4)EGFR、E-cadherin、AR在TNBC中表达情况:TNBC中,腋淋巴结阳性组的AR阳性率,EGFR阳性率,E-cadherin异常表达率高于腋淋巴结阴性组。结论:(1)TNBC组织学分级较差,预后较non-TNBC差。(2)TNBC中,EGFR的阳性表达,预示着病人预后差。腋淋巴结转越多,AR的表达率越低。(3)腋淋巴结是否转移可作为预测因素。(4)EGFR用于评价TNBC的预后。(5)AR可能成为新靶点。

Objective:Using immunohistochemical method to explore the pathological characteristics and prognosis of breast cancer three Yin type,detection of epidermal growth factor receptor(EGFR),epithelial calcium adhesion protein-cadherin(E)and androgen receptor(AR)respectively in three Yin three Yin expression in breast cancer,breast cancer and analyze its clinical significance.Methods:Selecting three Yin breast cancer(TNBC)and Yin(non-TNBC)50 cases of breast cancer,immunohistochemical method to detect the epidermal growth factor receptor(EGFR),calcium epithelial sex adhesion protein-cadherin(E),the expression of androgen receptor(AR),analysis their respective meaning expression,and the relationship between clinical factor and prognosis.Results:(1)The positive rate of EGFR in 100 cases of breast cancer was 48%(48/100),and the expression rate and AR positive rate were 53%(53/100)and 65%(65/100)respectively.(2)The 5-year DFS of e-cadherin normal expression group and AR positive group were higher than the e-cadherin abnormal expression group and AR negative group(P<0.05),and the difference was statistically significant.(3)Expression of EGFR,e-cadherin,AR in TNBC and non-nbc:the abnormal expression rate of EGFR and e-cadherin in TNBC was higher than non-tnbc,and the positive rate of AR was lower than non-tnbc(P<0.05),and the difference was statistically significant.(4)Expression of EGFR,e-cadherin and AR in TNBC:in TNBC,the AR positive rate of the axillary lymph node positive group,EGFR positive rate,e-cadherin abnormal expression rate was higher than the negative group of axillary lymph node.Conclusion:(1)TNBC histological classification is poor,and the prognosis is less than non-TNBC.(2)Positive expression of EGFR in TNBC indicates poor prognosis.The more the axillary lymph nodes turn,the lower the expression rate of AR.(3)Metastasis of axillary lymph nodes can be a predictor.(4)EGFR is used to evaluate the prognosis of TNBC.(5)AR may be a new target.