三阴性乳腺癌患者CD117、DOG1表达水平与临床病理特征及预后的相关性

Correlation of CD117 and DOG1 Expression with the Clinicopathological Features and Prognosis in Triple⁃negative Breast Cancer

目的 探究CD117、DOG1表达水平与三阴性乳腺癌(triple-negative breast cancer, TNBC)患者临床病理特征及预后的相关性。方法 回顾性纳入2000—2011年北京协和医院的TNBC患者。取其肿瘤组织芯片,采用免疫组化法检测肿瘤细胞中CD117、DOG1表达情况,分析二者与患者年龄、肿瘤直径、美国癌症联合委员会(American Joint Committee on Cancer, AJCC)分期、组织学分级、P53、Ki-67增殖指数等临床病理特征的关系,及其对患者生存期的影响。结果共入选符合纳入与排除标准的TNBC患者185例,其中CD117阳性24例(12.97%),DOG1阳性22例(11.89%),二者共表达率为1.62%。相较于肿瘤细胞CD117阴性患者,CD117阳性患者中高Ki-67增殖指数(87.50%比67.70%,P=0.048)、基底样TNBC(95.83%比74.53%,P=0.020)、P53弥漫强阳(33.33%比13.66%,P=0.032)的比例均更高。相较于DOG1阴性患者,DOG1阳性患者中肿瘤直径≤2 cm(22.73%比45.40%,P=0.026)、基底样TNBC(54.55%比80.37%,P=0.015)的比例均更低。中位随访时间71个月(范围:2~170个月),失访4例(2.16%),复发或远处转移66例(35.68%),死亡34例(18.38%)。生存分析显示,AJCC分期(HR=7.624,95%CI:2.187~26.576,P=0.001)及CD117阳性伴P53弥漫强阳(HR=3.942,95%CI:1.366~11.379,P=0.011)与TNBC患者总生存期呈负相关。结论 CD117阳性、DOG1阴性与基底样TNBC具有一定相关性,且CD117阳性伴P53弥漫强阳者总生存期更短,死亡风险增高。

Objective To investigate the expression of CD117 and DOG1 in triple-negative breast cancer(TNBC)and to explore their relationship with clinicopathologic features and prognosis.Methods The patients with TNBC in Peking Union Medical College Hospital from 2000 to 2011 were retrospectively collected and tissue microarrays were made.The expression of CD117 and DOG1 in tumor cells was detected by immuno-histochemistry to analyze their relationship with the clinicopathological characteristics of the patients,such as age,tumor diameter,American Joint Committee on Cancer(AJCC)cancer stage,histological grade,P53,and Ki-67 proliferation index,and explore the effect of both on the survival of patients.Results A total of 185 TNBC patients meeting the inclusion and exclusion criteria were selected,of which 24(1297%)were CD117 positive and 22(1189%)were DOG1 positive,with a co-expression rate of 162%.Compared with CD117-negative patients,CD117-positive patients had higher Ki-67 proliferation index(8750%vs 6770%,P=0048),basal-like TNBC(9583%vs 7453%,P=0020),and P53 diffuse positive(3333%vs 1366%,P=0032)Compared with DOG1-negative patients,DOG1-positive patients had lower proportions of tumor diameter≤2 cm(2273%vs 4540%,P=0026)and basal-like TNBC(5455%vs 8037%,P=0015).The median follow-up was 71 months(range:2-170 months),4 cases(216%)were lost to fol-low-up,66 cases(3568%)relapsed or had distant metastasis,and 34 cases(1838%)died.Survival analy-sis showed that AJCC stage(HR=7624,95%CI:2187-26576,P=0001)and CD117 positive with P53 diffuse strong positive(HR=3942,95%CI:1366-11379,P=0011)were negatively correlated with the overall survival of TNBC patients.Conclusions The expression of CD117 and DOG1 were significantly related to basal-like TNBC,CD117 positive with P53 diffuse strong positive may be correlated with a shorter overall survival and a higher mortality risk.