乳腺癌患者中医证型、VEGF-C、雌激素受体表达与预后的相关性

Correlation Analysis of TCM Syndrome Type, VEGF-C,Estrogen Receptor Expression and Prognosis in Patients with Breast Cancer

目的 分析乳腺癌患者中医证型、血管内皮生长因子C(VEGF-C)、雌激素受体(ER)表达与预后的相关性。方法 回顾性分析手术治疗的84例女性乳腺癌患者的病历资料,按中医证型的不同分为肝郁痰凝型(n=26)、冲任失调型(n=30)、正虚毒炽型(n=28)。以免疫组织化学染色法测定VEGF-C与ER表达;统计分析不同中医证型与患者临床病理特征、VEGF-C、ER的关系;所有患者均于术后进行1年的随访,分析患者临床病理特征、VEGF-C、ER表达与患者复发率的关系。结果 中医证型与乳腺癌患者的肿瘤最大径、淋巴结转移、病理学分级、TNM分期、VEGF-C、ER有关,差异有统计学意义(P<0.05);中医证型与患者年龄无关,差异无统计学意义(P>0.05)。随访1年,共有30例患者复发,复发率为35.71%(30/84);正虚毒炽型患者的复发率高于冲任失调型与肝郁痰凝型患者,VEGF-C阳性表达与ER阴性表达患者的复发率高于VEGF-C阴性表达与ER阳性表达患者,TNMⅢ期、有淋巴结转移、病理学分级Ⅲ级患者的复发率高于TNMⅠ~Ⅱ期、无淋巴结转移、病理学分级Ⅰ~Ⅱ级患者,差异有统计学意义(P<0.05);不同年龄、肿瘤最大径患者的复发率相比,差异无统计学意义(P>0.05)。结论 乳腺癌患者中医证型、VEGF-C、ER表达与患者预后联系紧密,正虚毒炽型、VEGF-C阳性表达、ER阴性表达患者的复发率更高,预后较差。

Objective To analyze the correlation between TCM syndrome types, expression of vascular endothelial growth factor C(VEGF-C),estrogen receptor(ER) and prognosis in breast cancer patients.Methods The medical records of 84 female breast cancer patients who underwent surgery were retrospectively analyzed.According to the different TCM syndrome types, they were divided into liver depression and phlegm coagulation type(n=26),Chong Ren disorder type(n=30) and Zheng Xu and Du Chi type(n=28).The expression of VEGF-C and ER was determined by immunohistochemical staining;Statistical analysis of the relationship between different TCM syndrome types and clinical pathological characteristics, VEGF-C,er;All patients were followed up for 1 year after operation to analyze the relationship between the clinicopathological characteristics, VEGF-C,ER expression and the recurrence rate of patients.Results TCM syndrome type was related to the maximum diameter of tumor, lymph node metastasis, pathological grade, TNM stage, VEGF-C and Er of breast cancer patients, and the difference was statistically significant(P<0.05);There was no significant difference between TCM Syndrome Types and patients’ age(P>0.05);During the follow-up of 1 year, 30 patients relapsed, with a recurrence rate of 35.71%(30/84);The recurrence rate of the patients with positive deficiency, toxin and blazing type was higher than that of the patients with Chong Ren disorder and liver stagnation and phlegm coagulation type.The recurrence rate of the patients with VEGF-C positive expression and ER negative expression was higher than that of the patients with VEGF-C negative expression and ER positive expression.The recurrence rate of the patients with TNM stage Ⅲ,lymph node metastasis and pathological grade Ⅲ was higher than that of the patients with TNM stage Ⅰ~Ⅱ,no lymph node metastasis and pathological grade Ⅰ~Ⅱ.The difference was statistically significant(P<0.05);There was no significant difference in the recurrence rate of patients with different age and tumor maximum diameter(P>0.05).Conclusion The TCM syndrome type, VEGF-C and ER expression in breast cancer patients are closely related to the prognosis of the patients.The recurrence rate and prognosis of the patients with positive deficiency and toxin type, VEGF-C positive expression and ER negative expression are higher.