异常糖链糖蛋白水平与乳腺癌分子分型及临床病理特征的相关性

Correlation between tumor abnormal protein level and molecular typing and clinicopathological characteristics in breast cancer

目的探讨乳腺癌中肿瘤异常糖链糖蛋白(tumor abnormal protein,TAP)水平与乳腺癌分子分型、临床病理特征的关系,分析TAP在乳腺癌筛查、诊断和预后中的价值。方法收集357例乳腺癌患者的临床资料,采集患者肘部静脉血检测TAP凝聚物面积。运用免疫组化EnVision两步法分析AR、ER、PR、HER2、p53、Ki67等表达,应用FISH检测HER2基因,分析TAP表达与乳腺癌临床病理特征、分子分型和临床分期的关系,并复习相关文献。结果357例乳腺癌患者中,TAP阴性9例(2.52%),TAP弱阳性36例(10.08%),TAP强阳性312例(87.40%),TAP阳性率为97.48%。免疫表型:AR阳性321例、阴性36例,ER阳性256例、阴性101例,PR阳性214例、阴性143例,HER2强阳性98例、弱阳性214例和阴性45例,p53阳性146例、阴性211例,Ki67增殖指数≥20%者276例、<20%者81例。FISH法:155例乳腺癌免疫组化HER2(2+)患者行FISH检测,其中140例阴性,15例阳性。≥50岁患者TAP表达水平明显高于<50岁患者(P<0.05),Ki67增殖指数高表达者的TAP表达水平高于Ki67低表达者(P<0.05)。不同分子分型乳腺癌患者的TAP表达差异有统计学意义(P<0.05);三阴型乳腺癌患者的TAP表达高于非三阴型患者(P<0.05),Luminal B型患者的TAP表达高于非Luminal B型患者(P<0.05);不同临床分期的乳腺癌患者TAP表达差异有统计学意义(P<0.05),在乳腺癌中TAP表达水平与临床分期呈正相关。结论TAP检测可提高乳腺癌诊断准确率,与乳腺癌患者生存率和预后有相关性。

Purpose To investigate the relationship between the level of tumor abnormal protein(TAP)and the molecular subtypes and clinicopathological features of breast cancer,and to analyze the value of TAP in breast cancer screening,diagnosis and prognosis prediction.Methods The clinical data of 357 breast cancer patients were collected,and the elbow venous blood was collected to detect the TAP condensate area.Immunohistochemical(IHC)EnVision two-step method was used to detect the expression of AR,ER,PR,HER2,p53 and Ki67,and FISH to detect HER2 gene.The relationship between TAP expression and clinicopathological features,molecular subtypes and clinical stages of breast cancer was analyzed,and the relevant literature was reviewed.Results Among 357 breast cancer patients,9 cases(2.52%)were TAP negative,36 cases(10.08%)were weakly positive,312 cases(87.40%)were strongly positive,and the positive rate of TAP was 97.48%.AR was positive in 321 cases and negative in 36 cases,ER was positive in 256 cases and negative in 101 cases,PR was positive in 214 cases and negative in 143 cases,HER2 was strongly positive in 98 cases,weakly positive in 214 cases and negative in 45 cases,p53 was positive in 146 cases and negative in 211 cases,Ki67 index was≥20%in 276 cases and<20%in 81 case.A total of 155 cases of IHC HER2(2+)breast cancer were tested by FISH:140 cases were negative and 15 cases were positive.The expression level of TAP in patients of≥50 years old expressionas significantly higher than that in patients of<50 years old(P<0.05).The expression level of TAP in patients with high Ki67 proliferation index was significantly higher than that in patients with low Ki67 proliferation index(P<0.05).There was a significant difference in TAP expression between patients with different molecular subtypes(P<0.05).Tap expression was higher in triple-negative breast cancer patients than in non-triple-negative breast cancer patients(P<0.05),and it was higher in Luminal B breast cancer patients than in non-Luminal B breast cancer patients(P<0.05).There was a significant difference in TAP expression between patients with different clinical stages(P<0.05),and TAP expression level was positively correlated with clinical stage in breast cancer.Conclusion TAP detection can improve the diagnostic accuracy of breast cancer,and has a certain correlation with the survival rate and prognosis of breast cancer patients.