953例乳腺癌患者CK5/6、EGFR和AR的表达与临床病理分析

Expression and clinicopathological analysis of CK5/6,EGFR and AR in 953 cases of breast cancer

目的:探讨细胞角蛋白5/6(CK5/6)、表皮生长因子受体(EGFR)、雄激素受体(AR)在乳腺癌中的表达与临床病理因素之间的关系。方法:回顾性分析2020年5月23日—2020年12月31日于天津医科大学肿瘤医院确诊为乳腺癌的953例患者的临床资料。分析雌激素受体(ER)、孕激素受体(PR)、人类表皮生长因子受体-2(Her-2)、细胞增殖核抗原、抑癌基因P53、CK5/6、EGFR、AR的表达情况。采用Spearman等级相关分析CK5/6、EGFR和AR的相关性,采用χ^(2)检验分析其与临床病理特征的关系,采用Logistic回归分析其独立影响因素。结果:CK5/6、EGFR和AR的阳性率分别为12.0%(114/953)、19.6%(187/953)和80.5%(810/953),并且CK5/6与EGFR的表达呈正相关(r=0.52,P<0.001),CK5/6与AR的表达呈负相关(r=-0.488,P<0.001),EGFR与AR的表达呈负相关(r=-0.310,P<0.001)。CK5/6的表达与分子分型(χ^(2)=229.777,P<0.001)、组织分级(χ^(2)=123.836,P<0.001)、临床分期(χ^(2)=11.620,P=0.031)以及是否发生远处转移有关(χ^(2)=6.516,P=0.036)。Luminal B型(OR=2.163,95%CI:1.052~4.444,P=0.036)、高组织学分级(OR=2.770,95%CI:1.483~5.171,P=0.001)和EGFR的阳性表达(OR=4.586,95%CI:2.408~8.734,P<0.000)是影响CK5/6表达的独立危险因素。EGFR的表达与发生远处转移有关(χ^(2)=7.437,P<0.001),而与累及淋巴结数量无关(χ^(2)=1.091,P=0.899)。Luminal B型(OR=3.106,95%CI:1.702~5.668,P=0.000)和P53(OR=1.779,95%CI:1.154~2.742,P=0.009)、CK5/6的阳性表达(OR=3.914,95%CI:2.212~6.928,P=0.000)是影响EGFR表达的独立危险因素。AR的表达与分子分型(χ^(2)=171.204,P<0.001)、组织学分级(χ^(2)=61.710,P<0.001)、临床分期(χ^(2)=11.224,P=0.038)和累及淋巴结数量有关(χ^(2)=12.427,P=0.012),ER(OR=27.712,95%CI:7.850~97.823,P=0.000)、PR(OR=4.904,95%CI:2.616~9.196,P=0.000)、Her-2(OR=13.209,95%CI:6.318~27.617,P=0.000)和Ki67(OR=4.677,95%CI:2.062~10.607,P=0.000)的阳性表达是影响AR表达的独立危险因素。结论:CK5/6、EGFR和AR的表达具有相关性,Luminal B型、高组织学分级、ER、PR、Her-2、P53和Ki67的阳性表达是CK5/6、EGFR和AR的危险因素。

Objective:To investigate the relationship between the expression of cytokeratin5/6(CK5/6),epidermal growth factor receptor(EGFR),androgen receptor(AR)in breast cancer and clinicopathological factors.Methods:The medical records of 953 patients diagnosed with breast cancer in Tianjin Medical University Cancer Hospital from May 23,2020 to December 31,2020 were retrospectively analyzed.The expression of estrogen receptor(ER),progesterone receptor(PR),human epidermal growth factor receptor 2(Her-2),cell proliferation nuclear antigen(Ki67),oncogene(P53),cytokeratin5/6(CK5/6),epidermal growth factor receptor(EGFR),and androgen receptor(AR)were detected.Spearman rank correlation analysis was used to analyze the correlation between CK5/6,EGFR and AR.Chi-square test was used to analyze its relationship with clinicopathological characteristics.Logistic regression analysis was used to analyze its independent influencing factors.Results:The positive rates of CK5/6,EGFR and AR were 12.0%(114/953),19.6%(187/953),and 80.5%(810/953),respectively.It was found that CK5/6 were positively correlated with EGFR(r=0.52,P<0.001),and CK5/6 was negatively correlated with AR(r=-0.488,P<0.001),and EGFR was negatively correlated with AR(r=-0.310,P<0.001).The expression of CK5/6 was related to differences in molecular typing(χ^(2)=229.777,P<0.001),tissue grade(χ^(2)=123.836,P<0.001),clinical stage(χ^(2)=11.620,P=0.031),and whether distant metastasis occured(χ^(2)=6.516,P=0.036).Luminal B type(OR=2.163,95%CI:1.052-4.444,P=0.036),high histological grade(OR=2.770,95%CI:1.483-5.171,P=0.001)and positive expression of EGFROR=4.586,95%CI:2.408-8.734,P<0.000 were independent risk factors affecting CK5/6 expression.The expression of EGFR was associated with the occurrence of distant metastasis(χ^(2)=7.437,P<0.001),and had nothing to do with the number of lymph nodes involved(χ^(2)=1.091,P=0.899).Luminal type B(OR=3.106,95%CI:1.702-5.668,P=0.000)and the positive expression of P53(OR=1.779,95%CI:1.154-2.742,P=0.009)and CK5/6(OR=3.914,95%CI:2.212-6.928,P=0.000)were independent risk factors affecting the expression of EGFR.The expression of AR was related to molecular typing(χ^(2)=171.204,P<0.001),histological grade(χ^(2)=61.710,P<0.001),clinical stage(χ^(2)=11.224,P=0.038)and the number of lymph nodes(χ^(2)=12.427,P=0.012)involved.The positive expression of ER(OR=27.712,95%CI:7.850-97.823,P=0.000),PR(OR=4.904,95%CI:2.616-9.196,P=0.000),Her-2(OR=13.209,95%CI:6.318-27.617,P=0.000)and Ki67(OR=4.677,95%CI:2.062-10.607,P=0.000)were independent risk factors for the expression of AR.Conclusion:The expression of CK5/6,EGFR are correlated with AR.Luminal type B,high histological grade,positive expression of ER,PR,Her-2,P53 and Ki67 are risk factors for CK5/6,EGFR and AR.