伴病理性乳头溢液的乳腺癌患者癌组织整合素β1的表达及意义

β1 integrin expression in breast cancer patients with pathological nipple discharge

目的:探讨整合素β1在伴病理性乳头溢液乳腺癌患者癌组织中的表达特征,及其对患者生存和预后的影响.方法:选取2006年1月1日—2013年12月31日期间,甘肃省人民医院收治的112例以乳头溢液就诊的乳腺癌患者作为研究对象,选取同期以乳房肿块或体检发现异常而就诊的112例乳腺癌患者作为对照,采用免疫组织化学方法检测整合素β1与Her-2在癌组织中的表达的差异,并分析整合素β1对乳腺癌预后的影响.结果:伴病理性乳头溢液组整合素β1阳性表达率为14.29%(16/112),低于对照组的25%(28/112),差异有统计学意义(χ^2=4.073,P=0.044).生存分析发现,对照组总生存期明显低于伴病理性乳头溢液组(HR=1.773,P=0.012);病理性乳头溢液组中整合素β1高表达患者的总生存期明显低于低表达者(HR=2.573,P=0.023);伴病理性乳头溢液组整合素β1的表达与Her-2水平呈正相关关系(r=0.281,P=0.001).Cox风险比例模型检验发现,淋巴结转移、组织学分级与整合素β1高表达是影响伴病理性乳头溢液组患者总生存期的3个独立危险因素(P<0.01).结论:整合素β1在乳腺癌组织中高表达可显著降低乳腺癌患者总生存期,且与乳腺癌的不良病理特点呈正相关.

OBJECTIVE: Expression of β1 integrin in breast cancer patients with pathological nipple discharge was investigated and its effect on prognosis of patients was evaluated. METHODS: From January 1st,2006 to December 31,2013,112 breast cancer patients with pathological nipple discharge in the People’s Hospital of Gansu Province were brought into the study. Another 112 breast cancer patients with breast lumps which were detected by physical examination or not were selected as a control. Immuno-histochemistry was used to detect the difference in expression of β1 integrin and Her-2 in cancer tissues. Survival analysis was used to study the effect of β1 integrin on prognosis of the patients. RESULTS: Among patients with pathological nipple discharge, 14.29%(16/112) showed positive expression of β1 integrin which was significantly lower than that in the control group (25%)(χ^2=4.073,P=0.044). Survival analyses show that the control group had significantly lower survival than that of the pathological nipple discharge group (HR=1.773, P=0.012). The overall survival with higher expression of β1 integrin was significantly lower than that of lower expression in the nipple discharge group (HR=2.573,P=0.023). The expression of β1 integrin and Her-2 had a positive correlation in the nipple discharge group (r=0.281, P=0.001), Cox proportional hazards model test found that histological grade, lymph node metastasis, and high expression of β1 integrin were three independent risk factors affecting the overall survival of patients with pathological nipple discharge (P<0.01). CONCLUSION: High expression of β1 integrin in breast cancer tissues significantly reduced the overall survival of breast cancer patients. Furthermore,breast cancer patients with integrin had lower overall survival, High expression of β1 integrin was positively correlated with poorer prognosis among breast cancer patients with pathological nipple discharge and was positively related to worse pathologic features of breast cancer.