P2X7受体在乳腺浸润性导管癌中的表达水平及临床意义

Expression of P2X7R in breast invasive ductal carcinoma and its prognostic value

目的:检测P2X7受体(P2X7 purinergic receptor,P2X7R)在乳腺浸润性导管癌中的表达水平,并探讨其表达水平与乳腺浸润性导管癌患者临床病理参数及预后的关系。方法:采用免疫组织化学法检测P2X7R在170例乳腺浸润性导管癌、50例乳腺导管原位癌和34例乳腺癌旁正常组织中的表达水平。采用χ~2检验分析P2X7R表达与乳腺癌患者临床病理指参数的关系,并用Kaplan-Meier法和COX风险回归模型分析P2X7R表达水平与患者预后的相关性。结果:P2X7R在浸润性导管癌和导管原位癌组织中均高表达,且明显高于乳腺癌旁正常组织(P<0.01);P2X7R表达水平与患者淋巴结转移(P=0.039)、TNM分期(P=0.045)、雌激素受体(estrogen receptor,ER)(P=0.024)和孕激素受体(progesterone receptor,PR)(P=0.033)的表达水平存在相关性,且P2X7R在淋巴结转移患者、TNMⅢ期患者、ER阳性患者和PR阳性患者中高表达率更高。P2X7R与患者年龄、肿瘤大小、组织学分级、人类表皮生长因子受体2(human epidermal growth factor receptor-2,HER-2)、p53和Ki-67无相关性。P2X7R高表达乳腺浸润性导管癌患者的无病生存(disease-free survival,DFS)时间较低表达者短(P=0.013)。单因素分析结果显示,乳腺浸润性导管癌患者的DFS与肿瘤大小(P=0.002)、淋巴结转移(P=0.009)、TNM分期(P<0.001)、Ki-67(P=0.026)和P2X7R(P=0.013)相关;多因素分析结果显示,TNM分期(P=0.033)和P2X7R(P=0.043)是影响乳腺浸润性导管癌患者DFS的独立危险因素。结论:P2X7R在乳腺癌中高表达,并且P2X7R高表达的乳腺癌患者预后更差,提示其可以作为一种乳腺癌的潜在预后标志物。

Objective:To detect the expression of P2X7 receptor(P2X7R)in breast invasive ductal carcinoma tissues,and to investigate the relationship of P2X7R expression with the clinicopathological features and prognosis of breast invasive ductal carcinoma patients.Methods:Immunohistochemical staining method was used to detect the expression of P2X7R in 170 cases of breast invasive ductal carcinoma,50 cases of breast ductal carcinoma in situ,and 34 cases of para-cancerous tissue.The relationship between P2X7R expression and clinicopathological features was analyzed byχ2 test.Kaplan-Meier method and COX proportional hazard model were used to analyze the relationship between P2X7R expression and the prognosis of patients.Results:P2X7R was highly expressed in both invasive ductal carcinoma tissues and ductal carcinoma in situ tissues,and the expression level of P2X7R in invasive ductal carcinoma tissues was significantly higher than that in the para-cancerous tissues(P<0.01).The expression level of P2X7R was correlated with lymph node metastasis(P=0.039),TNM stage(P=0.045),the expression of estrogen receptor(ER)(P=0.024)and progesterone receptor(PR)(P=0.033),and P2X7R had a higher expression rate in ER and PR positive,lymph node metastasis and TNM stageⅢpatients.But there was no correlation of P2X7R expression level with age,tumor size,and histologic grade,human epidermal growth factor receptor-2(HER-2),P53 and Ki-67.The disease-free survival(DFS)of patients with high P2X7R expression was shorter than those of patients with low P2X7R expression(P=0.013).Univariate analysis showed that the DFS was correlated with tumor size(P=0.002),lymph node metastasis(P=0.009),TNM stage(P<0.001),Ki-67(P=0.026)and P2X7R(P=0.013).Multivariate analysis showed that TNM stage(P=0.033)and P2X7R(P=0.043)were independent risk factors affecting the DFS of breast invasive ductal carcinoma patients.Conclusion:P2X7R is highly expressed in breast cancer tissues,and patients with high P2X7R expression have a poor prognosis.P2X7R can be used as a potential prognostic marker for breast cancer.