上皮钙黏蛋白在三阴性乳腺癌中的表达及其预后意义

Expression of epithelial-cadherin in triple negative breast cancer and its prognostic significance

目的探讨三阴性乳腺癌(TNBC)中上皮钙黏蛋白(E-cad)的表达情况及其对预后的影响。方法收集山西省肿瘤医院2009年4月至2012年4月收治的242例女性TNBC患者资料,用免疫组织化学法检测E-cad表达情况,应用Kaplan-Meier法和Cox比例风险回归模型分析E-cad表达对TNBC患者预后的影响。结果TNBC患者E-cad低表达率为59.5%(144/242),其表达与肿瘤临床TNM分期和淋巴结转移有关(均P<0.05)。242例患者中位总生存时间为70.7个月(7.2~95.9个月),50例(20.7%)患者死亡。3、5年的无病生存率分别为81.5%、78.1%,总生存率分别为86.5%、81.1%。E-cad低表达患者的无病生存及总生存率均低于高表达患者,差异均有统计学意义(均P<0.01)。Cox回归分析显示,E-cad是影响TNBC患者无病生存及总生存的独立预后因素(HR=0.144,95%CI 0.057~0.365,P<0.01;HR=0.196,95%CI 0.073~0.710,P<0.01)。结论E-cad低表达和TNBC的转移及预后差有关,其可作为TNBC患者一个重要的独立预后因子。

Objective To investigate the expression of epithelial-cadherin(E-cad)in triple negative breast cancer(TNBC)and its effect on the prognosis of TNBC.Methods The data of 242 female patients with TNBC in Shanxi Provincial Cancer Hospital from April 2009 to April 2012 were collected.Immunohistochemical staining was used to detect the expression of E-cad.Kaplan-Meier method and Cox proportional hazard regression model were conducted to analyze the effect of E-cad on the prognosis of TNBC patients.Results The low expression rate of E-cad in TNBC patients was 59.5%(144/242)and its expression was related to clinical TNM stage and lymph node metastasis(both P<0.05).The median overall survival time of 242 patients was 70.7 months(7.2-95.9 months),and 50(20.7%)patients died.The 3-year and 5-year disease-free survival(DFS)rate was 81.5%and 78.1%,and the overall survival(OS)rate was 86.5%and 81.1%,respectively.The DFS and OS rate in the E-cad low expression group were lower than those in the E-cad high expression group,and the difference was statistically significant(both P<0.01).Cox regression model demonstrated that E-cad was an independent prognostic factor of DFS and OS(HR=0.144,95%CI 0.057-0.365,P<0.01;HR=0.196,95%CI 0.073-0.710,P<0.01).Conclusion The low expression of E-cad is correlated with metastasis and the poor prognosis of TNBC,which could be an independent prognostic factor for TNBC patients.