睾丸因子样蛋白2的表达与乳腺恶性叶状肿瘤预后的关系

Relationship between the P-element induced wimpy testis like 2 expression and prognosis of breast malignant phyllodes tumor

目的探究睾丸因子样蛋白2(Piwil2)的表达与乳腺恶性叶状肿瘤预后的关系。方法收集2000年3月至2012年6月期间中国人民解放军陆军第八十一集团军医院及陆军总医院乳腺叶状肿瘤患者资料123例,其中乳腺良性叶状肿瘤41例、交界性叶状肿瘤32例,恶性叶状肿瘤50例,同时选取因乳腺炎切除的乳腺正常组织70例作为对照组。采取免疫组化染色EnVision两步法检测Piwil2蛋白的表达情况。分析Piwil2阳性表达情况与乳腺恶性叶状肿瘤患者病理参数之间的关系;利用Kaplan-Meier法进行乳腺恶性叶状肿瘤患者5年生存分析;COX回归分析影响乳腺恶性叶状肿瘤患者预后不良的危险因素。结果免疫组化结果显示Piwil2定位于肿瘤细胞的细胞质,细胞周期蛋白D1(CyclinD1)定位于细胞核,乳腺叶状肿瘤组织中Piwil2、CyclinD1蛋白阳性表达率分别为86.18%(106/123)、76.42%(94/123),明显高于正常乳腺组织的11.43%(8/70)、8.57%(6/70),差异均有统计学意义(P<0.05)。Piwil2蛋白表达情况与乳腺叶状肿瘤患者肿瘤分型、临床分期、分化程度、淋巴结转移有关(P<0.05)。乳腺叶状肿瘤组织中Piwil2、CyclinD1蛋白表达水平相关(χ^(2)=6.037,P=0.014)。Piwil2蛋白高表达和低表达患者平均生存时间分别为34.5个月(95%CI:29.6339.44)、56.4个月(95%CI:50.0961.71),Log-Rank检验差异有统计学意义(χ^(2)=4.629,P=0.031)。多因素分析结果显示,分化程度低、淋巴结转移、Piwil2蛋白高表达是影响乳腺恶性叶状肿瘤患者预后不良的危险因素(P<0.05)。结论乳腺恶性叶状肿瘤患者肿瘤组织中Piwil2蛋白呈高表达,是影响乳腺恶性叶状肿瘤患者预后不良的危险因素。

Objective To investigate the relationship between the P-element induced wimpy testis like 2(Piwil2)expression and the prognosis of breast malignant phyllodes tumor.Methods From March 2000 to June 2012,123 patients with breast phyllodes tumor in the PLA 81 st Group Military Hospital and the General Hospital of the People’s Liberation Army were collected,including 41 cases of benign phyllodes tumor,32 cases of borderline phyllodes tumor and 50 cases of malignant phyllodes tumor.Meanwhile,70 cases of normal breast tissue resected due to mastitis were selected as control group.The expression of Piwil2 protein was detected by EnVision two-step immunohistochemical staining.The relationship between Piwil2 positive expression and pathological parameters of breast malignant phyllodes tumor was analyzed;KaplanMeier method was used to analyze the 5-year survival of patients with breast malignant phyllodes tumor;COX regression analysis was used to analyze the risk factors of poor prognosis in patients with breast malignant phyllodes tumor.Results Immunohistochemistry showed that Piwil2 was located in the cytoplasm of tumor cells;CyclinD1 protein was located in the nucleus;the positive expression rates of Piwil2 and CyclinD1 protein in breast phyllodes tumor were 86.18%(106/123)and76.42%(94/123),respectively,which were significantly higher than those of 11.43%(8/70)and 8.57%(6/70)in normal breast tissues(P<0.05).The expression of Piwil2 protein was correlated with tumor type,clinical stage,differentiation degree and lymph node metastasis(P<0.05).The protein expression levels of Piwil2 and CyclinD1 protein in breast phyllodes tumor tissue was related(χ^(2)=6.037,P=0.014).The mean survival time of patients with high and low Piwil2 expression was 34.5 months(95%CI:29.63-39.44)and 56.4 months(95%CI:50.09-61.71),respectively,Log-Rank test showed that the difference was statistically significant(χ^(2)=4.629,P=0.031).Multivariate analysis showed that low differentiation,lymph node metastasis and high expression of Piwil2 protein were risk factors for poor prognosis in patients with breast malignant phyllodes tumor(P<0.05).Conclusion The Piwil2 protein in breast malignant phyllodes tumor tissue was highly expressed,and it could be a risk factor for poor prognosis of patients with breast malignant phyllodes tumor.