乳腺癌组织表皮生长因子受体、细胞角蛋白5/6、上皮钙黏蛋白表达与预后的关系研究

Study on the Relationship between the Expression of Epidermal Growth Factor Receptor,Cytokeratin 5/6,Epithelial Cadherin and Prognosis in Breast Cancer Tissues

目的:探讨乳腺癌组织表皮生长因子受体(EGFR)、细胞角蛋白5/6(CK5/6)、上皮钙黏蛋白(E-Cad)表达与预后的关系。方法:选取我院(2015年1月~2017年12月)收治的100例接受乳腺外科手术治疗的乳腺癌患者,免疫组织化学检测乳腺癌组织和癌旁组织中EGFR、CK5/6、E-Cad表达。比较乳腺癌组织与癌旁组织中EGFR、CK5/6、E-Cad的阳性表达率,分析乳腺癌组织中EGFR、CK5/6、E-Cad表达与临床病理特征的关系,Kaplan-Meier曲线分析EGFR、CK5/6、E-Cad不同表达患者的无病生存期(DFS)和总生存期(OS)曲线,多因素Cox回归分析乳腺癌预后的影响因素。结果:乳腺癌组织中EGFR、CK5/6的阳性表达率明显高于癌旁组织,E-Cad的阳性表达率明显低于癌旁组织(P<0.05)。乳腺癌组织中EGFR、E-Cad阳性表达率与分化程度、TNM分期相关(P<0.05),与年龄、肿瘤直径、病理类型无关(P>0.05);CK5/6阳性表达率与年龄、肿瘤直径、分化程度、TNM分期无关(P>0.05),与病理类型相关(P<0.05)。Kaplan-Meier生存曲线显示,EGFR、CK5/6阳性表达患者3年DFS和OS明显低于阴性表达患者,E-Cad阳性表达患者3年DFS和OS明显高于阴性表达患者(P<0.05)。多因素Cox回归分析显示,TNM分期Ⅲ期(HR=5.756,95%CI:1.535~21.591)、EGFR阳性(HR=8.090,95%CI:0.954~68.616)、CK5/6阳性(HR=4.507,95%CI:0.466~43.593)为乳腺癌预后独立危险因素,E-Cad阳性(HR=0.221,95%CI:0.048~1.020)为乳腺癌预后独立保护因素(P<0.05)。结论:乳腺癌组织中EGFR、CK5/6表达明显升高,E-Cad表达明显降低,三者为乳腺癌患者预后独立影响因素。

Objective:To investigate the relationship between the expression of epidermal growth factor receptor(EGFR),cytokeratin 5/6(CK5/6),epithelial cadherin(E-Cad)and prognosis in breast cancer tissues.Methods:A total of 100 breast cancer patients who underwent breast surgery were selected from our hospital(January 2015 to December 2017)were selected,immunohistochemistry was used to detect EGFR,CK5/6,E-Cad in breast cancer tissues and adjacent tissues expression.The positive expression rates of EGFR,CK5/6,E-Cad in breast cancer tissues and adjacent tissues were compared,the relationship between EGFR,CK5/6,E-Cad expression in breast cancer tissues and clinicopathological characteristics were analyzed.Kaplan-Meier curve was used to analyze the disease free survival(DFS)and overall survival(OS)curves of patients with different expression of EGFR,CK5/6 and E-Cad.Multivariate Cox regression analysis was used to analyze the prognostic factors of breast cancer.Results:The positive expression rates of EGFR and CK5/6 in breast cancer tissues were significantly higher than those in adjacent tissues,and the positive expression rate of E-Cad was significantly lower than that in adjacent tissues(P<0.05).The positive expression rates of EGFR and E-Cad in breast cancer were correlated with differentiation degree and TNM stage(P<0.05),but they were not related to age,tumor diameter and pathological type(P>0.05).The positive expression rate of CK5/6 was not related to age,tumor diameter,differentiation degree and TNM stage(P>0.05),but was related to pathological type(P<0.05).Kaplan-Meier survival curve showed that 3-year DFS and OS of patients with positive expression of EGFR and CK5/6 were significantly lower than those with patients with negative expression.The 3-year DFS and OS of patients with E-Cad positive expression were significantly higher than those with patients with negative expression(P<0.05).Multivariate Cox regression analysis showed that TNM stage III(HR=5.756,95%CI:1.535~21.591),EGFR positive(HR=8.090,95%CI:0.954~68.616),CK5/6 positive(HR=4.507,95%CI:0.466~43.593)were independent risk factors for the prognosis of breast cancer,E-Cad positive(HR=0.221,95%CI:0.048~1.020)were independent protective factors for the prognosis of breast cancer(P<0.05).Conclusion:The expressions of EGFR and CK5/6 in breast cancer tissues are significantly increased,and the expression of E-Cad is significantly decreased,which were independent influencing factors for the prognosis of patients with breast cancer.