不同中医证型乳腺癌患者的预后与ER、PR、HER-2受体相关性分析

Analysis of Prognosis of Breast Cancer Patients with Different Chinese Medicine Syndromes and their Correlation with ER,PR and HER-2 Receptors

目的:探讨不同中医证型的乳腺癌患者预后及其与雌激素受体(ER)、孕激素受体(PR)、人类表皮生长因子受体2 (HER-2)的相关性。方法:选取100例乳腺癌患者展开回顾性研究,依据中医证型不同分为肝郁气滞证组(45例)、肝肾阴虚证组(32例)、血瘀证组(23例),比较3组TNM分期、病理组织学分级及ER、PR、HER-2、乳腺癌抑癌基因(P53)、血管生长因子(VEGF)表达情况。结果:3组患者TNM分期比较,差异有统计学意义(P<0.05);且血瘀证组TNM分期高于肝肾阴虚证组、肝郁气滞证组(P<0.05),肝肾阴虚证组TNM分期高于肝郁气滞证组(P<0.05)。3组患者病理组织学分级比较,差异有统计学意义(P<0.05);且血瘀证组病理组织学分级高于肝肾阴虚证组、肝郁气滞证组(P<0.05),肝肾阴虚证组病理组织学分级高于肝郁气滞证组(P<0.05)。3组ER、PR水平表达比较,差异无统计学意义(P>0.05),其中以肝郁气滞证组ER、PR阳性率最高。3组HER-2水平表达比较,差异有统计学意义(P<0.05);且血瘀证组HER-2阳性率显著高于肝郁气滞证组、肝肾阴虚证组(P<0.05)。3组P53水平表达比较,差异无统计学意义(P>0.05),其中以血瘀证组P53阳性率最高。3组VEGF表达比较,差异有统计学意义(P<0.05),且血瘀证组VEGF阳性率显著高于肝郁气滞证组、肝肾阴虚证组(P<0.05)。结论:不同中医证型乳腺癌患者病理分型、病理组织学分级存在差异,其预后与ER、PR、HER-2受体表达密切相关。

Objective:To investigate the prognosis of breast cancer patients with different Chinese medicine syndromes and its correlation with estrogen receptor(ER), progesterone receptor(PR) and human epidermal growth factor receptor-2(HER-2). Methods: A total of 100 breast cancer patients were retrospectively studied. According to different Chinese medicine syndromes,they were divided into the liver depression and qi stagnation syndrome group(45 cases),the liverkidney yin deficiency syndrome group(32 cases), and the blood stasis syndrome group(23 cases). The TNM staging,histopathological grading and the expression of ER,PR,HER-2,breast cancer suppressor gene(P53) and vascular growth factor(VEGF) were compared between the three groups. Results:There was significant difference in the comparison of TNM staging between the three groups(P<0.05);the TNM staging in the blood stasis syndrome group was higher than that in the liver-kidney yin deficiency syndrome group and the liver depression and qi stagnation syndrome group(P<0.05);the TNM staging in the liver-kidney yin deficiency syndrome group was higher than that in the liver depression and qi stagnation syndrome group(P<0.05). The histopathological grading in the three groups was compared,the difference being significant(P<0.05);the histopathological grading in the blood stasis syndrome group was higher than that in the liver-kidney yin deficiency syndrome group and the liver depression and qi stagnation syndrome group(P<0.05);the histopathological grading in the liver-kidney yin deficiency syndrome group was higher than that in the liver depression and qi stagnation syndrome group(P<0.05). There was no significant difference in the comparison of the ER and PR expression between the three groups(P>0.05),and the positive rates of ER and PR were the highest in the liver depression and qi stagnation syndrome group(P<0.05). There was significant difference in the comparison of the HER-2 expression between the three groups(P<0.05),and the positive rate of HER-2 in the blood stasis syndrome group was significantly higher than that in the liver depression and qi stagnation syndrome group and the liver-kidney yin deficiency syndrome group(P<0.05). There was no significant difference in the comparison of the expression of P53(P>0.05), and the positive rate of P53 was the highest in the blood stasis syndrome group. There was significant difference in the comparison of the VEGF expression between the three groups(P<0.05), and the positive rate of VEGF in the blood stasis syndrome group was significantly higher than that in the liver depression and qi stagnation syndrome group and the liver-kidney yin deficiency syndrome group(P<0.05). Conclusion:There are differences in pathological classification and histopathological grading of breast cancer patients with different Chinese medicine syndromes,and their prognosis is closely related to the expression of ER,PR and HER-2 receptors.