同源盒基因MEOX2在乳腺癌中的表达及其临床意义

Expression of MEOX2 in Breast Cancer and Its Clinical Significance

[目的]研究乳腺癌组织中MEOX2的表达水平与临床病理资料的相关性,及其对患者预后的影响。[方法]纳入2010—2012年嘉兴市第一医院乳腺病科就诊的乳腺癌患者162例,免疫组化检测组织中MEOX2的表达水平,将患者分为低表达组及高表达组。利用Cox回归模型进行多因素分析,并应用Kaplan-Meier曲线评估患者无复发生存(recurrence free survival,RFS)和总生存(overall survival,OS),Log-rank检验比较生存曲线差异。[结果]MEOX2主要定位于细胞核中,在乳腺癌中表达的阳性率为83.33%(135/162),其中MEOX2低表达的患者有50.62%(82/162),高表达的患者有49.38%(80/162)。MEOX2低表达组患者脉管癌栓的发生率更高(P=0.029)。预后分析结果显示MEOX2高表达与不良预后有关,MEOX2高表达的患者RFS更差(P=0.028),但OS未见统计学差异(P=0.323)。多因素分析显示淋巴结受累、Ki67水平及MEOX2表达水平均为乳腺癌患者发生复发转移事件的独立预测因素。淋巴结受累是发生死亡事件的独立预测因素(P=0.001)。在雌激素受体阴性人类表皮生长因子受体2阳性的乳腺癌患者中,MEOX2高表达与较差的RFS有关(P=0.096),但未达统计学意义;而在其他分型的患者中,MEOX2与预后无明显相关性。[结论]乳腺癌组织中MEOX2表达水平与脉管癌栓相关,其高表达与患者的复发转移事件及不良预后相关,这一相关性在ER阴性Her-2阳性的患者中较为明显。MEOX2可作为乳腺癌患者复发转移事件的预测标志物。

[Objective]To investigate the correlation between MEOX2 expression and clinicopathological features in breast cancer patients,and the impact of MEOX2 on prognosis in these patients.[Methods]We included 162 patients who received surgical treatment from 2010 to 2012.Immunohistochemistry was used to examine the expression of MEOX2.Patients were divided into two groups according to MEOX2 expression.Univariate analysis and Cox regression multivariate analysis were used in order to analyze the correlation between MEOX2 expression and clinicopathological features.Kaplan-Meier curve and Log-rank analysis were used to evaluate recurrence free survival(RFS)and overall survival(OS).[Results]MEOX2 was mostly expressed in nuclear with expression rate of 83.33%(135/162).Of which,50.62%(82/162)of patients were low MEOX2 expression and 49.38%(80/162)were high expression.Low MEOX2 expression was significantly correlated with more lymphovascular invasion(P=0.029).Increased MEOX2 was associated with poor prognosis.Compared with low expression,patients with high MEOX2 expression had worse RFS(P=0.028),while OS did not reach statistical difference(P=0.323).Multivariate analysis showed axillary status,Ki67 level and MEOX2 expression were independent predictors of recurrence and metastasis in breast cancer patients,and axillary status was the only independent predictor of death event(P=0.001).Subgroup analysis showed the high expression of MEOX2 was associated with poor prognosis in patients with ER-and Her-2+(P=0.096),while did not reach statistical difference.No association between MEOX2 and prognosis was found in other subgroups.[Conclusion]MEOX2 expression is correlated with lymphovascular invasion in breast cancer patients.High expression is associated with recurrence,metastasis and poor prognosis.This correlation is more obvious in ER-Her-2+patients.Thus,MEOX2 may be a potential biomarker on predicting recurrence,metastasis and prognosis in breast cancer patients.