再生胰岛衍生家族成员4在不同分子分型乳腺癌中的表达及其与预后的关系

The expression and clinical importance of Reg Ⅳ in different molecular subtypes of breast cancer

目的再生胰岛衍生家族成员4(Reg Ⅳ)与多种肿瘤的发生发展密切相关,但在浸润性乳腺癌中鲜见报道。文中旨在检测Reg Ⅳ在腺腔A型(LA)、腺腔B型(LB)、HER-2过表达型(HER-2+)和三阴性(TNBC)4种不同分子分型乳腺癌中的表达情况及与临床病理特征、生存预后之间的关系。方法收集2011年3月至2017年10月连云港市第一人民医院病理科284例乳腺癌患者的病理资料。分析Reg Ⅳ在不同分子分型(LA、LB、HER-2+和TNBC型)中的表达情况及与临床病理特征之间的关系;分析数据库内Reg ⅣmRNA在乳腺癌中的表达水平及与患者预后的关系。结果 Reg Ⅳ在LA型、LB型、HER-2+及TNBC型乳腺癌中的阳性率分别为52.11%、50.00%、65.22%、20.00%,组间比较差异有统计学意义(P<0.01)。Reg Ⅳ在乳腺癌中的表达与肿瘤直径、淋巴结转移、TNM分期相关(P<0.05)。Reg Ⅳ高表达的乳腺癌患者复发风险明显低于低表达者(HR=0.59,95%CI:0.50～0.69),进一步分析发现Reg Ⅳ高表达的LA乳腺癌患者复发风险明显低于低表达者(HR=0.63,95%CI:0.48～0.82),Reg Ⅳ高表达的LB乳腺癌患者复发风险明显低于低表达者(HR=0.56,95%CI:0.40～0.76),Reg Ⅳ高表达的TNBC乳腺癌患者复发风险明显低于低表达者(HR=0.51,95%CI:0.36～0.71)。结论 Reg Ⅳ可为乳腺癌的分子分型诊断提供参考,并可作为评估乳腺癌不同分子分型患者预后良好的指标之一。

Objective RegⅣ,which is the latest member of the regenerative gene family,has been found to be closely related to the development of various tumors,but rarely reported in invasive breast cancer.This article is intended to explore the expression levels of regenerative factor 4(regeneration islet-derived family,member 4,RegⅣ),and the correlation with clinicopathological features and prognosis in 4 molecular subtypes of breast cancer(LA,LB,HER-2+,TNBC).Methods Pathological data of 284 breast cancer patients from March 2011 to October 2017 in the department of pathology,Lianyungang first people’s hospital were collected.To analyze the expression of RegⅣin different molecular subtypes(LA,LB,HER-2+,TNBC)and its relationship with clinicopathological features,we analyzed the expression level of RegⅣmRNA in breast cancer and its prognosis of patients.Results The positive rates of RegⅣin Luminal A group,Luminal B group,HER-2 positive group and triple negative breast cancer were 52.11%(37/71),50.00%(42/84),65.22%(45/69)and 20.00%(12/60),which was statistically significant when comparing them in pairs(P<0.01).The expression of RegⅣwas associated with tumor diameter,lymph node metastasis,TNM stage(P<0.01).The recurrence risk of breast cancer patients with high RegⅣexpression was lower than those with low RegⅣexpression(HR=0.59,95%CI:0.50-0.69).Further analysis found that the recurrence risk of LA breast cancer patients with high RegⅣexpression(HR=0.63,95%CI:0.48-0.82),and so it was with LB(HR=0.56,95%CI:0.40-0.76)and TNBC(HR=0.51,95%CI:0.36-0.71).Conclusion RegⅣcan provide reference for molecular subtypes diagnosis and it may be one of the indicators to evaluate the prognosis of breast cancer patients.