c-erbB-2、PTEN在乳腺癌中的表达及其意义

The expression and significance of c-erbB-2 and PTEN in breast cancer

目的 :探讨 c- erb B- 2和 PTEN表达与乳腺癌临床病理参数和预后关系。方法 :对 6 0例行根治或改良根治术的乳腺癌患者进行随访分析 ,石蜡标本行免疫组化 S- P法检测 c- erb B- 2和 PTEN蛋白的表达。结果 :(1) c- erb B- 2阳性表达主要在细胞膜 ,阳性率为 6 5 .0 % ,其中 +2 0 .0 % , 2 3.3% , 2 1.7% ;PTEN的表达主要定位于乳腺小叶腺泡上皮细胞及导管上皮细胞的胞质 , 4 3.3% ,+36 .7% ,- 2 0 .0 %。 (2 ) c- erb B- 2的表达与淋巴结转移、组织学分级正相关 (P<0 .0 5 ,P<0 .0 1) ,与 ER表达呈负相关 (P<0 .0 1)。PTEN的表达与组织学分级及淋巴结状况呈负相关 (P<0 .0 5 )。 (3)单因素分析显示 c- erb B- 2和 PTEN的表达是预后相关因素 ,c- erb B- 2表达与总生存、无瘤生存相关 (P<0 .0 5 ) ,PTEN与总生存相关 (P<0 .0 5 )。 (4 ) c- erb B- 2表达与 PTEN的表达无显著相关 (P>0 .0 5 ) ,同时存在 c- erb B- 2过表达和 PTEN失表达的乳腺癌患者预后更差。结论 :乳腺癌发生发展中存在多种基因变异 ,c- erb B- 2过度表达与 PTEN的失表达共同促进了肿瘤的发生发展 ,联合检测两者在乳腺癌中的表达情况有助于乳腺癌患者的预后判断 ,为进一步的临床治疗提供依据。

Objective:To determine the expressions of c-erbB-2 and PTEN and their relationships with clinicopathologic parameters and prognosis in breast cancer.Methods:60 cases conducted radical or modified radical mastectomy were followed and studied ,paraffin-embedded specimens were detected c-erbB-2 and PTEN expression by using immunohistochemical S-P method.Results:(1)The staining of c-erbB-2 was localized in cellar membrane and the positive rate was 65%(+20%,23.3%,21.7%).the staining of PTEN was localized in cytoplasm of epithelium cells of lobular acini and epithelium cells of ducts.20.0% breast carcinoma tissues were negative of PTEN protein ,36.7% had weak expression of PTEN and 43.3% had strong expression .(2)The expression of c-erbB-2 was related to the status of axillary lymph node or histological grade and inversely correlated with the estrogen receptor (ER) status.There was inverse relation between the expression of PTEN and the status of axillary lymph node or histological grade.(3)A unifactor analysis indicated that c-erbB-2 had a significant prognostic value in both the overall survival (OS) and the disease free survival (DFS). PTEN demonstrated a prognostic significance only for OS.(4) There was no significant association between the expression of c-erbB-2 and PTEN (P>0.05). A unifactor analysis also indicated a subgroup with high c-erbB-2 expression and low PTEN expression have both a worse DFS and OS than the other subgroups.Conclusion:This study suggested that the mutation of gene of c-erbB-2 and PTEN play a pivotal role in the development and metastatic behavior of primary breast carcinoma,therefore adjuvant therapies after surgery were necessary.