p53和Bcl-2阳性表达与乳腺癌患者临床特征的关系

Correlation between positive expression of p53 and Bcl-2 and the clinical characteristic of breast cancer patients

目的探讨p53及Bcl-2阳性表达与乳腺癌患者临床特征的关系。方法选取122例乳腺癌患者。分析p53及Bcl-2阳性表达与乳腺癌患者临床特征[年龄、肿瘤最大径、病理类型、临床分期、组织分化程度、腋窝淋巴结转移情况、雌激素受体(ER)、孕激素受体(PR)、人类表皮生长因子受体2(HER2)及Ki-67]的关系。采用Logistic回归分析进行多因素分析,筛选p53及Bcl-2阳性表达相关危险因素。结果不同临床分期、组织分化程度的乳腺癌患者的p53及Bcl-2阳性表达率比较,不同肿瘤最大径的乳腺癌患者的Bcl-2阳性表达率比较,差异均有统计学意义(P﹤0.05);有腋窝淋巴结转移、ER阴性、PR阴性的乳腺癌患者的p53阳性表达率均明显高于无腋窝淋巴结转移、ER阳性、PR阳性的患者(P﹤0.01);无腋窝淋巴结转移的乳腺癌患者的Bcl-2阳性表达率明显高于有腋窝淋巴结转移的患者(P﹤0.01)。多因素分析结果提示,有腋窝淋巴结转移、临床分期为Ⅲ期及低分化均是p53阳性表达的独立危险因素(P﹤0.01),ER阳性表达是p53阳性表达的保护因素(P﹤0.01);临床分期为Ⅲ期、低分化、有腋窝淋巴结转移均是Bcl-2阳性表达的保护因素(P﹤0.01)。结论p53及Bcl-2阳性表达与乳腺癌患者的临床特征密切相关,检测p53及Bcl-2的阳性表达情况对评估乳腺癌患者的病情及预后有一定的参考价值。

Objective To investigate the correlation between the positive expression of p53 and Bcl-2 and the clinical characteristics of breast cancer patients. Method A total of 122 patients with breast cancer were enrolled in the study. The relationship between the positive expression of p53 and Bcl-2 and the clinical characteristics [age, maximum tumor diameter, pathological type, clinical stage, histological grade, axillary lymph node metastasis, estrogen receptor (ER), progestogen receptor (PR), human epidermal growth factor receptor 2 (HER2) and Ki-67] in breast cancer patients was analyzed. Logistic regression analysis was utilized to screen for risk factors associated with positive p53 and Bcl-2 expression. Result The positive expression rate of p53 and Bcl-2 differed significantly among breast cancer patients with different clinical stage and histological grade, while breast cancer patients with different maximum tumor diameter had varied Bcl-2 positive expression rate, with statistical significance (P<0.05);axillary lymph node metastasis, ER negative, and PR negative were associated with higher positive expression rate of p53 compared to those with negative lymph node metastasis, ER positive and PR positive patients of breast cancer (P<0.01);the positive expression rate of Bcl-2 among patients with negative axillary lymph node metastasis was significantly higher than that of those with positive axillary lymph node metastasis (P<0.01). Multivariate analysis indicated that the independent risk factors for p53 positive expression were axillary lymph node metastasis, clinical stage III, and low differentiation (P<0.01), while protective factor was ER positive expression (P<0.01);protective factors for positive expression of Bcl-2 included clinical stage III, low histological grade and positive axillary lymph nodes (P<0.01). Conclusion The positive expression of p53 and Bcl- 2 in breast cancer are closely related to the clinical characteristics of those patients, thus the detection of p53 and Bcl-2 is somewhat meaningful value for evaluating the medical conditions and prognosis of breast cancer patients.