涎腺导管癌AR、HER-2和Ki-67蛋白的表达及分子分型

Molecular classification and expression of AR,HER-2 and Ki-67 proteins in salivary duct carcinoma

目的 分析AR、HER-2和Ki-67蛋白在涎腺导管癌组织中的表达水平,探讨涎腺导管癌的分子分型。方法 手术切除或活检病理诊断为涎腺导管癌的石蜡标本29例。免疫组化法检测涎腺导管癌组织中雄激素受体(AR)、人表皮生长因子受体-2(HER-2)和Ki-67蛋白的表达,荧光原位杂交(FISH)检测HER-2基因表达,并据AR、HER-2、Ki-67三者的表达情况对涎腺导管癌进行分子分型,分析不同分子分型与临床病理特征的关系及预后。结果 29例SDC组织中AR阳性率为82.76%(24/29),HER-2阳性率为55.17%(16/29),Ki-67高表达率为55.17%(16/29);AR的表达与HER-2的表达具有相关性(P<0.05)。不同分子分型与年龄、性别、肿瘤直径、肿瘤发生部位、淋巴结受累、组织学分级均无相关性(P>0.05)。年龄<65岁、AR高表达及HER-2低表达的患者预后较好;AR^+/HER-2^-/Ki-67低表达的患者预后优于其他任何一种分型的患者(P<0.05)。结论 大多数涎腺导管癌表达AR和HER-2,同时AR和HER-2的状态有助于预测SDC患者的预后,建立分子分型对SDC患者的预后有一定的参考价值。

Objective To analyze the expression of androgen receptor,HER-2 and Ki-67 proteins in ductal carcinoma of salivary gland,and to explore the molecular classification of salivary duct carcinoma.Methods A total of 29 cases of salivary duct carcinoma pathologically diagnosed by resection or biopsies were selected from January 2009 to June 2018.Immunohistochemical staining was performed to detect the expression of AR,HER-2 and Ki-67 in salivary duct carcinoma,and HER-2 was detected by fluorescence in situ hybridization.According to the expression of AR,HER-2 and Ki-67,the molecular classification was performed,and the relationship between different molecular types and clinicopathological features and prognosis was analyzed.Results The AR positive rate was 82.76%(24/29)in 29 SDC cases.The HER-2 positive rate was 55.17%(16/29).The high expression rate of Ki-67 was 55.17%(16/29).The expression of AR was correlated with the expression of HER-2(P<0.05).The molecular types were not correlated with age,gender,tumor diameter,tumor location,lymph node involvement and histological grade(P>0.05).Patients with age<65 years,high AR expression,and low HER-2 expression had a better prognosis.Patients with low AR^+/HER-2^-/Ki-67 expression had a better prognosis than patients with any other types(P<0.05).Conclusion Most of the salivary duct carcinoma patients expresses AR and HER-2,and the status of AR and HER-2 can help predict the prognosis of patients with SDC.The establishment of molecular typing has certain reference value for the prognosis of patients with SDC.