叉头框蛋白P3在乳腺癌放疗患者中的表达及临床意义

Expression and clinical significance of forkhead box P and clinical significance of forkhead box P3 in breast cancer patients undergoing radiotherapy

目的 探讨叉头框蛋白P3(FOXP3)在乳腺癌放疗患者中的表达及临床意义。方法 选取90例乳腺癌放疗患者和30例乳腺纤维腺病患者,采用免疫组化染色法检测FOXP3表达情况,比较乳腺癌组织和乳腺纤维腺病组织中FOXP3表达情况,比较不同临床特征及分子分型乳腺癌患者乳腺癌组织中FOXP3表达情况,采用多因素Logistic回归模型分析乳腺癌患者中FOXP3阳性表达的影响因素。比较不同FOXP3表达情况乳腺癌患者的放疗疗效及无病生存期(DFS),采用Cox比例风险模型分析乳腺癌放疗患者DFS的影响因素。结果 乳腺癌组织中FOXP3阳性表达率为38.9%,明显低于乳腺纤维腺病组织的76.7%(P﹤0.01)。多因素Logistic回归分析结果显示,临床分期、Ki-67表达情况、淋巴结转移情况均是乳腺癌患者中FOXP3阳性表达的独立影响因素(P﹤0.05)。Luminal A型乳腺癌患者乳腺癌组织中FOXP3阳性表达率高于Luminal B型、三阴性、人表皮生长因子受体2(HER2)过表达型乳腺癌患者,差异均有统计学意义(P﹤0.05)。FOXP3阳性表达乳腺癌患者的局部失败率为2.9%,明显低于FOXP3阴性表达患者的25.5%(P﹤0.01)。FOXP3阳性表达乳腺癌患者的DFS明显优于FOXP3阴性表达患者(P﹤0.01)。Cox比例风险回归分析结果显示,FOXP3阳性表达、雌激素受体(ER)阳性表达均是乳腺癌放疗患者DFS的独立保护因素(P﹤0.05)。结论 乳腺癌组织中FOXP3阳性表达率较低,FOXP3阳性表达乳腺癌患者放疗局部失败率低于FOXP3阴性表达患者,且预后优于FOXP3阴性表达患者,FOXP3有望为乳腺癌的诊断、个体化治疗及预后评估提供新思路。

Objective To investigate the expression and clinical significance of forkhead box P3(FOXP3)in breast cancer patients undergoing radiotherapy.Method A total of 90 radiotherapy patients for breast cancer and 30 patients with fibroadenomas were selected.The expression of FOXP3 was detected by immunohistochemical staining.The expres-sion of FOXP3 in breast cancer tissues and breast fibroadenomas tissues was compared.The expression of FOXP3 in breast cancer tissues of breast cancer patients with different clinical characteristics and molecular types were compared.Multivariate Logistic regression model was built to analyze the influencing factors of FOXP3 positive expression in breast cancer patients.The radiotherapy efficacy and disease-free survival(DFS)of breast cancer patients with different FOXP3 expression were compared.Cox proportional hazards model was used to analyze the influencing factors for DFS in breast cancer patients undergoing radiotherapy.Result The positive expression rate of FOXP3 in breast cancer tissues was 38.9%,which was significantly lower than 76.7%in breast fibroadenomas tissues(P<0.01).The results of multivari-ate Logistic regression analysis showed that clinical stage,Ki-67 expression,and lymph node metastasis were indepen-dent influencing factors for the positive expression of FOXP3 in breast cancer patients(P<0.05).The positive expression rate of FOXP3 in breast cancer tissues of patients with Luminal A type breast cancer was higher than that of Luminal B type,triple negative,and human epidermal growth factor receptor 2(HER2)overexpression type patients,and the differ-ences were statistically significant(P<0.05).The local failure rate of FOXP3-positive breast cancer patients was 2.9%,which was significantly lower than 25.5%of FOXP3-negative breast cancer patients(P<0.01).The DFS of breast cancer patients with FOXP3 positive expression was better than that of breast cancer patients with FOXP3 negative expression(P<0.01).The results of Cox proportional hazards regression analysis showed that the positive expression of FOXP3 and the positive expression of estrogen receptor(ER)were independent protective factors for DFS in breast cancer patients undergoing radiotherapy(P<0.05).Conclusion The positive expression rate of FOXP3 in breast cancer tissues was low.The radiotherapy local failure rate of FOXP3-positive breast cancer patients was lower than that of FOXP3-negative pa-tients,and the prognosis was better than that of FOXP3-negative patients.FOXP3 is expected to provide new ideas for the diagnosis,individualized treatment and prognosis evaluation of breast cancer.