乳腺癌原发灶与淋巴结转移灶分子标志物表达差异的回顾性研究

Retrospective study of the differences of biomarker expression between primary lesions of breast cancer and corresponding lymph node metastases

目的 探讨乳腺癌原发灶与同期同侧淋巴结转移灶之间雌激素受体、孕激素受体、人表皮生长因子受体2、Ki-67蛋白的表达差异及其临床意义.方法 回顾性分析北京大学第一医院2012年1月-2016年5月收治的156例浸润性乳腺癌患者的病例资料,并对乳腺癌原发灶与淋巴结转移灶雌激素受体、孕激素受体、人表皮生长因子受体2、Ki-67蛋白的表达差异进行分析.计数资料以百分率表示,组间比较采用McNemar检验.结果 156例患者中,2例(1.3％)原发灶与转移灶之间雌激素受体表达状态不同(P=0.500);10例(6.4％)原发灶与转移灶之间孕激素受体表达状态不同(P=0.344);28例(18.0％)原发灶与转移灶之间Ki-67蛋白表达状态不同(P =0.000 18);3例(1.9％)原发灶与转移灶之间人表皮生长因子受体2表达状态不同(P=1.000).其余患者各标志物在原发灶与转移淋巴结之间表达状态未出现差异.结论 雌激素受体、孕激素受体、人表皮生长因子受体2、Ki-67蛋白在乳腺癌原发灶和淋巴结转移灶的表达可能出现差异,可为乳腺癌个体化治疗提供参考.

Objective To investigate the difference of the expression of estrogen receptor,progesterone receptor,human epidermal growth factor receptor 2 and Ki-67 protein between primary lesions of breast cancer and its synchronous ipsilateral lymph node metastasis,as well as its clinical implications.Methods Retrospectively analyze invasive breast cancer patients treated in Peking University First Hospital from January 2012 to May 2016.The IHC expressions of estrogen receptor,progesterone receptor,human epidermal growth factor receptor 2 and Ki-67 protein in both the primary and lymph node metastatic lesions are compared and analyzed statistically.The count data were represented as n(％),and comparsion between groups were evaluated using the McNemar test.Results One hundred and fifty-six patients were included,of which on 2 cases (1.3％),estrogen receptor status of primary lesions is different from that of lymph node metastases(P =0.500);on 10 cases (6.4％),progesterone receptor status of primary lesions is different from that of lymph node metastases (P =0.344);on 28 cases (18.0％),Ki-67 protein status of primary lesions is different from that of lymph node metastases (P =0.000 18);on 3 cases (1.9％),human epidermal growth factor receptor 2 status of primary lesions is different from that of lymph node metastases (P =1.000).Conclusion There may be difference between primary lesions and lymph node metastases in the expression of estrogen receptor,progesterone receptor,human epidermal growth factor receptor 2 and Ki-67 protein,which can provide a reference for individualized treatment of breast cancer patients.