乳腺癌HER2、孕激素受体表达与生存期相关性的研究

Association of progesterone receptor and HER2 expressions with the survival time of patient with breast cancer

目的研究乳腺癌HER2、孕激素受体(PR)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HER2和PR的表达,并随访其生存时间。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%;(2)HER2、PR的阳性表达率分别为57.8%和62.7%;(3)HER2和PR各级生存率表达曲线比较,统计学有显著性意义(P<0.01),其中HER2与生存率呈负相关,PR与生存率呈正相关;(4)单变量分析表明:HER2是一个危险因素,影响生存时间缩短(P<0.01);PR是一个保护因素,其高表达预示生存期长(P<0.01)。(5)HER2联合PR多变量分析,只有PR有显著性意义(P=0.012)。结论HER2和PR均是乳腺癌独立的预后指标,HER2高表达提示预后不良,而PR高表达则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 expressions of progesterone receptor (PR) and HER2 in the tumor tissues of patients with breast cancer, thereby to explore the possibility of using the 2 indices as the indicator for the prognosis of the patients. Method Immunohistochemical staining for PR and HER2 was performed on paraffin embedded tumor specimens obtained from 185 patients with breast cancer, and follow-up studies were conducted and the survival time of the patients recorded. Results In the 120 patients (64.9%) with complete followed-up data, 28 patients died (15%), with the record of the other 65 patients (35.1%) not available for this study. Immunohistochemical detection found that the positivity rates for HER2 and PR were 57.8% and 62.7% respectively in the total specimens examined, and HER2 and PR showed significant difference in their respective associations with the survival rate of the patients (P<0.01). Specifically, HER2 was inversely associated with the survival rate, to which PR was positively related. The univariant analysis suggested the hazards posed by HER2 expression to reduce the overall survival of the patients (P<0.01, OR=1.566), while PR, playing the protective role, was associated with a significantly longer overall survival time (P<0.01, OR=0.547). In the multivariate analysis, however, only PR expression was of significant prognostic value in the patients (P=0.012). Conclusion Both HER2 and PR can be used as independent indicators for the prognosis of patients with breast cancer, and high HER2 expression may indicate poor prognosis, while PR is associated with a longer survival time and a higher survival rate.