免疫组织化学指标在乳腺癌原发灶和复发转移灶之间的表达差异

Discordance of Estrogen Receptor,Progesterone Receptor,Cerb-B2, Ki- 67 Index and P53 Expressions between Primary and Recurrent or Metastatic Sites in Breast Cancer Patients

目的观察雌激素受体(ER)、孕激素受体(PR)、Cerb-B2、Ki-67指数和P53状态在乳腺癌原发灶和复发转移灶之间的表达差异。方法回顾性分析2001年1月至2015年2月北京协和医院收治的56例复发转移性乳腺癌患者的临床及病理资料,分析ER、PR、Cerb-B2、Ki-67指数和P53状态的表达特点并进行统计分析。结果乳腺癌从原发灶到复发转移灶,ER阳性率由60.7%变为57.1%,表达不一致率为12.5%(7/56);PR阳性率由55.4%变为44.6%,表达不一致率为16.1%(9/56);Cerb-B2阳性率由19.1%变为29.5%,表达不一致率为9.1%(4/44);Ki-67指数表达不一致率为24.5%(12/49);P53阳性率由37.5%变为55.6%,表达不一致率为13.3%(6/45)。结论检测复发转移灶的免疫组织化学指标可能对复发转移性乳腺癌的综合治疗具有指导意义。

Objective To approach the discordance of estrogen receptor(ER),progesterone receptor(PR),Cerb-B2,Ki-67 index and P53 expressions between primary and regional or distant recurrent lesions in recurrent or metastatic breast cancer patients. Methods Clinical and pathological data of 56 recurrent or metastatic breast cancer patients who were treated in Peking Union Medical College Hospital from January 2001 to February 2015 were retrospectively analyzed.The changes in the expressions of ER,PR,Cerb-B2,Ki-67 index, and P53 status were analyzed. Results The hormone receptor positive rate between primary tumor and recurrent or metastatic sites decreased from 60.7% to 57.1% for ER and from 55.4% to 44.6% for PR,respectively.Changes in hormone receptor status were seen at the rate of 12.5%(7/56)and 16.1%(9/56) for ER and PR,respectively.Cerb-B2 receptor positive rate increased from 19.1% to 29.5% and the discordance rate was 9.1%(4/44).The discordance rate of Ki-67 index was 24.5%(12/49).The P53 receptor positive rate increased from 37.5% to 55.6% and the discordance rate was 13.3%(6/45). Conclusion Although the relevant rules of above changes are still controversial,these findings still have great clinical significance for making effective treatment decisions of recurrent or metastatic breast cancer.