P53在浸润性乳腺癌中的表达及意义

Significance of P53 expression in invasive breast cancer

目的探讨P53在浸润性乳腺癌中的表达情况及其与临床病理特征的相关性。方法收集南通市肿瘤医院病理科2015年1月—2017年12月存档的浸润性乳腺癌标本709例。采用免疫组化方法检测标本中P53蛋白的表达,分析P53与浸润性乳腺癌分子分型、组织学类型及雌激素受体(ER)、孕激素受体(PR)、人类表皮生长因子受体2(HER-2)及Ki-67之间的关系。结果 P53高表达占26.8%(190/709),低表达占73.2%(519/709)。P53在Luminal A型、HER-2阴性Luminal B型、HER-2阳性Luminal B型、HER-2过表达型及三阴型浸润性乳腺癌中的高表达率分别为6.1%(12/197)、18.0%(34/189)、39.1%(25/64)、50.0%(58/116)、42.7%(61/143),差异有统计学意义(P<0.05)。P53在伴有髓样特征的乳腺癌中表达率高于其他组织学类型(P<0.05)。组织学分级越高,P53表达率越高(P<0.05)。P53在ER阴性组、PR阴性组、HER-2阳性组及Ki-67高表达组中表达率较高(均P<0.05)。结论 P53与浸润性乳腺癌发生发展密切相关,可作为临床判断预后及指导个体化治疗的参考指标。

Objective To investigate the expression of P53 and its correlation with clinicopathological characteristics in invasive breast cancer.Methods A total of 709 cases of invasive breast cancer were collected in the Nantong Cancer Hospital from January 2015 to December 2017. The expressions of P53 in 709 cases were detected with immunohistochemistry. The expression of P53 and its correlation with molecular classifications, histologic grades and expressions of estrogen receptor(ER), progesterone receptor(PR), human epidermal growth factor receptor 2(HER-2) and Ki-67 were investigated and analyzed.Results The high positive rate of P53 was 26.8%(190/709), low positive rate of P53 was 73.2%(519/709). The high positive rate of P53 in luminal subtype A, luminal subtype B with negative HER-2, luminal subtype B with positive HER-2, HER-2 over-expressing subtype and triple negative subtype were 6.1%(12/197), 18.0%(34/189), 39.1%(25/64), 50.0%(58/116) and 42.7%(61/143), respectively. There were significant differences in expressions of P53 between five luminal subtypes(P<0.05). The expression level of P53 was higher in breast cancer with medullary histological features than that in other histologic subtypes(P<0.05). The expression of P53 increased with the rise of histologic grades(P<0.05). The expression level of P53 was higher in breast cancer with ER negative, PR negative, HER-2 positive and high Ki-67 expression groups(all P<0.05).Conclusion P53 plays a significant role in the development and progression of invasive breast cancer. The expression of P53 can be used to guide the individualized therapy and as a reference index to clinical outcome prediction in invasive breast cancer.