乳腺癌HER-2和ER表达与生存期相关性的研究

Research on the Relationship between the Survival Time and the Expression of ER and HER-2 in Breast Cancer

目的:研究乳腺癌HER2、ER与生存期的关系,探讨其成为乳腺癌预后指标的可行性。方法:采用免疫组化检测185例乳腺癌标本的HER2和ER的表达,并对其生存时间随访。结果:①有10年内预后随访资料者120例,占总人数的64.9％;其中死亡28例,占15％;失访65例,占35.1％。②HER2、ER的阳性总表达率分别为:57.8％和64.3%。③HER2和ER各级表达与生存率曲线比较,统计学有显著差异,P均小于0.01。HER2与生存率呈负相关,ER与生存率呈正相关。④单变量分析,HER2是一个危险因素,可使生存时间缩短(P<0.01),OR值为1.566。ER是一个保护因素,它的高表达预示生存期长(P<0.01),OR值为0.416。⑤HER2联合ER多变量分析,只有ER有显著意义(P=0.002)。⑥HER2与ER表达呈负相关。结论:HER2和ER均是乳腺癌独立的预后指标。HER2高表达提示预后不良,ER高表达预示患者有较高的生存率和较长的生存期。

Objective: To investigate the relationship between the survival time and the expression of ER and HER-2 of breast cancer patients. And then made a feasible study to measure this one or two markers to discuss the significance to predict the prognosis. Methods; We selected 185 samples and measured the expression of ER and HER-2 in the way of immunohistochemistry (IHC) , and followed-up the survival time. Results: (1)120 patients (64.9% ) were followed-up, 28 patients had died (15% ) , the other 65 patients hadn't got touch (35. 1% ). (2)The positive rates for HER2 and ER were 57. 8% and 64. 3%. (3)The survival experience of HER2 and ER were significant among each grade of them. (P < 0. 01, P < 0. 01) . HER 2 was associated with a significantly lower survival rate and ER was associated with higher survival rate. (4)In single-variable analysis; HER2 was associated with a significantly shorter overall survival ( P < 0. 01, OR = 1. 566 ) . ER was associated with a significantly longer overall survival (P < 0. 01, OR = 0. 416). (5)In the multivariate analysis, only the ER was of significant prognostic value on survival time (P =0.002).(6)The correlation between HER2 and ER were negative. Conclusion: In breast cancer specimens, both HER2 and ER were found significant prognostic value. The overexpression of HER2 may be related to poorly prognosis. The overexpression of ER may be related to a longer survival time and a higher survival rate.