乳腺导管内增生性病变中cyclin D1蛋白表达与浸润性癌的相关性

Relationship between the expression of cyclin D1 protein in breast duct hyperplastic lesions and invasive carcinoma

目的探讨乳腺导管内增生性病变中cyclin D1蛋白表达与浸润性癌的关系。方法选取乐山市市中区人民医院2006年7月~2014年7月期间首诊确诊存档的乳腺组织石蜡标本,且符合纳入与排除标准的样本共180例,其中癌旁组织24例(癌旁组)、浸润性癌组织74例(浸润性癌组)、乳腺导管内增生性病变组织82例[包括普通型导管增生(UDH)20例(UDH组)、柱状细胞病变(CCL)15例(CCL组)、非典型导管增生(ADH)22例(ADH组)、导管原位癌(DCIS)25例(DCIS组)]。采用免疫组织化学法检测各组织中cyclin D1蛋白表达情况,分析cyclin D1阳性表达与浸润性乳腺癌病理特征及预后的关系。结果各组组织中cyclin D1蛋白阳性表达率组间比较差异均有统计学意义(P<0.05),与DCIS组和浸润性癌组相比,癌旁组、UDH组、CCL组的cyclin D1蛋白阳性表达率较低,差异有统计学意义(P<0.05);cyclin D1蛋白阳性表达与浸润性乳腺癌肿瘤直径、TNM分期、组织学分级、淋巴结转移等密切相关(P<0.05);cyclin D1阴性组5年总生存率高于cyclin D1阳性组,两组Kaplan Merier比较,差异有统计学意义(P<0.05);TNM分期、淋巴结转移、cyclin D1阳性是影响浸润性乳腺癌预后的独立危险因素(P<0.05)。结论cyclin D1在乳腺导管内增生性病变中表达水平高可能为浸润性癌的危险因素,cyclin D1表达水平越高,浸润性癌风险越大,预后越差。

Objective To investigate the expression level of cyclin D1 protein in breast intraductal proliferative lesions and its relationship with invasive cancer.Methods From July 2006 to July 2014,a total of 180 paraffin specimens of breast tissue were selected,which met the inclusion and exclusion criteria.Immunohistochemistry was used to detect the expression of cyclin D1 protein in each tissue,and the relationship between cyclin D1 positive expression and the pathological features and prognosis of invasive breast cancer was analyzed.Results Compared with DCIS group and invasive carcinoma group,the positive expression rate of cyclin D1 protein was lower in the paracancerous group,udh group and CCL group(P<0.05).The positive expression of cyclin D1 protein was closely related to tumor diameter,TNM stage,histological grade and lymph node metastasis in invasive breast cancer(P<0.05).The 5-year overall survival rate of cyclin D1 negative group was higher than that of cyclin D1 positive group,and the difference was statistically significant(P<0.05).TNM stage,lymph node metastasis and cyclin D1 positive were independent risk factors for prognosis of invasive breast cancer(P<0.05).Conclusion The expression level of cyclin D1 in breast duct proliferative lesions may be a risk factor for invasive carcinoma.The higher the expression level of cyclin D1,the greater the risk of invasive carcinoma and the worse the prognosis.