绝经前后乳腺浸润性导管癌的蛋白表达及预后生存分析
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摘要
目的探讨绝经前后ER、PR、HER-2表达及其与临床病理特征相关性,并分析其预后生存情况。方法采用免疫组化法检测山东省菏泽市成武县人民医院2011年1月—2015年1月期间收治的156例乳腺浸润性导管癌患者肿瘤组织ER、PR、HER-2的表达,并根据患者绝经与否分为绝经组与未绝经组。统计学分析未绝经组(60例)与绝经组(96例)患者ER、PR、HER-2表达的差异及其对肿瘤大小、TNM分期等临床病理参数的影响,并对其中66例患者进行随访,分析其预后生存情况。结果绝经组患者共96例,其ER、PR、HER-2阳性率分别为76.0%,59.4%,17.7%,未绝经组患者共60例,其ER、PR、HER-2阳性率分别是40.0%,28.3%,63.3%,两组患者三者的表达均差异有统计学意义(P<0.05)。患者是否绝经与乳腺浸润性导管癌中ER、PR、HER-2阳性表达及三阴性乳腺癌呈现明显线性相关(P<0.05),而与肿瘤直径、TNM分期未呈现明显线性相关性(P>0.05)。生存分析中,绝经组存活率(67.57%)高于未绝经组(37.93%),死亡率(18.92%)低于未绝经组(48.28%),预后生存期较未绝经组长。结论乳腺浸润性导管癌患者蛋白的差异性表达和预后生存状况与是否绝经关系密切,是否绝经对乳腺浸润性导管癌治疗方案的选择及预后判定有重要参考意义。
Objective To study the correlation between the ER, PR, HER-2 expression and clinical pathological features before and after menopause and analyze the prognosis survival situation. Methods The ER, PR, HER-2 expressions of tumor tissues of patients with breast infiltrating ductal carcinoma from January 2011 to January 2015 was tested by the immunohistochemistry, and divided into the menopause group and non-menopause group, and the effect of differences in the ER、PR、HER-2 of patients in the non-menopause group with 60 cases and menopause group with 96 cases on the tumor size and TNM stage was statistically analyzed, and 66 cases of patients were followed up, and the survival prognosis situation was analyzed. Results In the menopause group, the positive rates of ER、PR、HER-2 was respectively 76.0%,59.4%,17.7%, and in the non-menopause group, the positive rate of ER、PR、HER-2 was respectively 40.0%,36.7%,63.3%, and the difference in the expression between the two groups was statistically significant(P<0.05), and whether the patients were with menopause or not had an obvious liner correlation with the positive expression of ER, PR, HER-2 and TNBC(P<0.05), and had an obvious liner correlation with the tumor diameter and TNM stage(P>0.05), and the survival analysis showed that the survival rate in the menopause group was higher than that in the non-menopause group(67.57% vs 37.93%), and the morbidity was lower than that in the non-menopause group,(18.92% vs 48.28%), and the prognosis survival stage was longer than that in the non-menopause group. Conclusion The difference expression of protein of patients with breast infiltrating ductal carcinoma is closely correlated with the prognosis survival situation, and menopause is of important reference significance to the selection of treatment plan of breast infiltrating ductal carcinoma and determination of prognosis.
Objective To study the correlation between the ER, PR, HER-2 expression and clinical pathological features before and after menopause and analyze the prognosis survival situation. Methods The ER, PR, HER-2 expressions of tumor tissues of patients with breast infiltrating ductal carcinoma from January 2011 to January 2015 was tested by the immunohistochemistry, and divided into the menopause group and non-menopause group, and the effect of differences in the ER、PR、HER-2 of patients in the non-menopause group with 60 cases and menopause group with 96 cases on the tumor size and TNM stage was statistically analyzed, and 66 cases of patients were followed up, and the survival prognosis situation was analyzed. Results In the menopause group, the positive rates of ER、PR、HER-2 was respectively 76.0%,59.4%,17.7%, and in the non-menopause group, the positive rate of ER、PR、HER-2 was respectively 40.0%,36.7%,63.3%, and the difference in the expression between the two groups was statistically significant(P<0.05), and whether the patients were with menopause or not had an obvious liner correlation with the positive expression of ER, PR, HER-2 and TNBC(P<0.05), and had an obvious liner correlation with the tumor diameter and TNM stage(P>0.05), and the survival analysis showed that the survival rate in the menopause group was higher than that in the non-menopause group(67.57% vs 37.93%), and the morbidity was lower than that in the non-menopause group,(18.92% vs 48.28%), and the prognosis survival stage was longer than that in the non-menopause group. Conclusion The difference expression of protein of patients with breast infiltrating ductal carcinoma is closely correlated with the prognosis survival situation, and menopause is of important reference significance to the selection of treatment plan of breast infiltrating ductal carcinoma and determination of prognosis.
引文
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[13]肖建军,陶敏,段卫明,等.乳腺癌绝经前后c-erb B-2、ER、PR的表达及与预后的相关性[J].肿瘤防治研究,2009,23(5):666-668.
[14]马传栋,陈小松,柳光宇,等.老年乳腺癌的临床病理特点和治疗[J].中华外科杂志,2008,46(18):1397-1399.
[15]Inal A,Akman T,Yaman S,et al.Pathologic and clinical characteristics of elderly patients with breast cancer:a retrospective analysis of a multicenter study(Anatolian Society of Medical Oncology)[J].Int Surg,2014,99(1):2-7.
[16]Syed BM,Green AR,Paish EC,et al.Biology of primary breast cancer in older women treated by surgery:with correlation with long-term clinical outcome and comparison with their younger counterparts[J].Br J Cancer,2013,108(5):1042-1051.
[17]Mc Namara KM,Yoda T,Takagi K,et al.Androgen receptor in triple negative breast cancer[J].J Steroid Biochem Mol Biol,2013(133):66-76.
[2]De Santis C,Ma J,Bryan L,et al.Breast cancer statistics,2013[J].CA Cancer J Clin,2014,64(1):52-62.
[3]Hong W,Dong E.The past,present and future of breast cancer research in China[J].Cancer Lett,2014,351(1):1-5.
[4]Hudis CA,Gianni L.Triple-negative breast cancer:an unmet medical need[J].Oncologist,2011(16 Suppl 1):1-
[5]Alfred R,Chin S,Williams E,et al.The prevalence and significance of estrogen receptor(ER)positivity in breast cancer at the University Hospital of the West Indies,Jamaica[J].West Indian Med J,2012,61(8):795-801.
[6]Omranipour R,Alipour S,Hadji M,et al.Accuracy of estrogen and progesterone receptor assessment in core needle biopsy specimens of breast cancer[J].Iran Red Crescent Med J,2013,15(6):515-518.
[7]Habashy H,Powe D,Ellis I,et al.A review of the biological and clinical characteristics of luminal-like estrogen receptor-positive breast cancer[J].Histopathology,2012,60(6):854-863.
[8]董春鸽,章杰,吴亮,等.乳腺癌伴神经内分泌分化与预后因素的相关性[J].温州医学院学报,2011,41(2):132-135.
[9]刘裔莎,魏兵,杨雯娟,等.美国癌症联合会乳腺癌分期(第七版)简介[J].中华病理学杂志,2010,39(11):787-790.
[10]Daniel AR,Hagan CR,Lange CA.Progesterone receptor action:defininga role in breast cancer[J].Expert Rev Endocrinol Metab,2011,6(3):359-369.
[11]张军强,孙智国,王登强,等.青年乳腺癌患者的临床病理特征、分子分型及预后情况分析[J].实用癌症杂志,2015,30(4):527-530.
[12]史建军,刘涛,李珂,等.110例青年女性乳腺癌预后分析[J].中国妇幼保健,2014,29(9):1348-1350.
[13]肖建军,陶敏,段卫明,等.乳腺癌绝经前后c-erb B-2、ER、PR的表达及与预后的相关性[J].肿瘤防治研究,2009,23(5):666-668.
[14]马传栋,陈小松,柳光宇,等.老年乳腺癌的临床病理特点和治疗[J].中华外科杂志,2008,46(18):1397-1399.
[15]Inal A,Akman T,Yaman S,et al.Pathologic and clinical characteristics of elderly patients with breast cancer:a retrospective analysis of a multicenter study(Anatolian Society of Medical Oncology)[J].Int Surg,2014,99(1):2-7.
[16]Syed BM,Green AR,Paish EC,et al.Biology of primary breast cancer in older women treated by surgery:with correlation with long-term clinical outcome and comparison with their younger counterparts[J].Br J Cancer,2013,108(5):1042-1051.
[17]Mc Namara KM,Yoda T,Takagi K,et al.Androgen receptor in triple negative breast cancer[J].J Steroid Biochem Mol Biol,2013(133):66-76.