增殖细胞核抗原Ki-67与早期乳腺癌前哨淋巴结转移及分子分型表达变化的相关性研究
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摘要
目的探讨增殖细胞核抗原Ki-67的表达与早期乳腺癌前哨淋巴结转移之间的关系,并分析其与雌激素受体ER、孕激素受体PR及HER-2表型状态之间的相关性。方法回顾性分析2016-2018年收治的50例早期乳腺癌前哨淋巴结转移患者的资料,比较原发灶与前哨淋巴结转移灶中Ki-67的表达水平,并分析Ki-67的表达是否会改变ER、PR、HER-2的表型状态。结果 Ki-67表达与患者肿瘤大小(P=0.038)、组织学分级(P=0.020)及HER-2表达(P=0.028)呈正相关;与原发灶相比,Ki-67在前哨淋巴结转移灶中表达水平更高;原发灶和前哨淋巴结转移灶中Ki-67的表达水平与ER、PR、HER-2的表型状态无相关性。结论 Ki-67高表达可能是促进早期乳腺癌向前哨淋巴结转移的危险因素,但其表达水平并不影响ER、PR、HER-2的表型状态。
Objective To explore the relationship between the expression of proliferative cell nuclear antigen Ki-67 and early breast cancer with sentinel metastasis, and to analyze its correlation with the estrogen receptor(ER), progesterone receptor(PR) and HER-2 phenotype status. Methods Fifty patients with early-stage breast cancer sentinel lymph node metastasis in our hospital were retrospectively analyzed. Compare the expression level of Ki-67 in the primary and sentinel lymph node metastases, and analyze whether the expression of Ki-67 would change the phenotype of ER, PR and HER-2. Results The expression of Ki-67 was positively correlated with tumor size(P=0.038), histological classification(P=0.020) and HER-2 expression(P=0.028). Compared with the primary lesion, Ki-67 had higher expression level in sentinel lymph node metastasis. No correlation was found between the expression of Ki-67 in the primary and sentinel lymph node metastases and the phenotypic states of ER, PR and HER-2. Conclusion High expression of Ki-67 may be a risk factor for early breast cancer metastasis to the sentinel node, but its expression changes do not affect the phenotype status of ER, PR and HER-2.
Objective To explore the relationship between the expression of proliferative cell nuclear antigen Ki-67 and early breast cancer with sentinel metastasis, and to analyze its correlation with the estrogen receptor(ER), progesterone receptor(PR) and HER-2 phenotype status. Methods Fifty patients with early-stage breast cancer sentinel lymph node metastasis in our hospital were retrospectively analyzed. Compare the expression level of Ki-67 in the primary and sentinel lymph node metastases, and analyze whether the expression of Ki-67 would change the phenotype of ER, PR and HER-2. Results The expression of Ki-67 was positively correlated with tumor size(P=0.038), histological classification(P=0.020) and HER-2 expression(P=0.028). Compared with the primary lesion, Ki-67 had higher expression level in sentinel lymph node metastasis. No correlation was found between the expression of Ki-67 in the primary and sentinel lymph node metastases and the phenotypic states of ER, PR and HER-2. Conclusion High expression of Ki-67 may be a risk factor for early breast cancer metastasis to the sentinel node, but its expression changes do not affect the phenotype status of ER, PR and HER-2.
引文
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[16]袁琳,周文辉,赵卫卫,等. Ki-67在乳腺癌组织中的表达及其临床意义研究[J].国际检验医学杂志, 2017, 38(11):1464-1467. doi:10.3969/j. issn.1673-4130.2017.11.009.
[17]Ohara M, Matsuura K, Akimoto E, et al. Prognostic value of Ki67 and p53 in patients with estrogen receptor-positive and human epidermal growth factor receptor 2-negative breast cancer:Validation of the cut-off value of the Ki67 labeling index as a predictive factor[J]. Mol Clin Oncol, 2016,4(4):648-654. doi:10.3892/mco.2016.776.
[18]焦得闯,乔江华,卢振铎,等.早期乳腺癌前哨淋巴结阳性预测因素分析[J].中华肿瘤杂志, 2014, 36(3):198-201.doi:10.3760/cma. j. issn.0253-3766.2014.03.008.
[19]王慧,王靖,高纪东,等.乳腺癌前哨淋巴结和非前哨淋巴结转移的影响因素分析[J].中华肿瘤杂志, 2013,35(10):769-772. doi:10.3760/cma. j. issn.0253-3766.2013.10.011.
[2]李旻,谢博遥,何国栋,等.术中细胞学印片法诊断乳腺癌前哨淋巴结转移的准确性分析[J].临床肿瘤学杂志,2016, 21(10):919-922. doi:10.3969/j. issn.1009-0460.2016.10.011.
[3]Cabanas RM. An approach for the treatment of penile carcinoma[J]. Cancer, 1977, 39(2):456-466.
[4]叶春梅,熊斌,胡俊波,等.量子点技术检测乳腺癌前哨淋巴结转移的研究[J].中华实验外科杂志, 2016, 33(7):1826-1829. doi:10.3760/cma. j. issn.1001-9030.2016.07.036.
[5]雷海,黄晓蓉,闫珊玲,等.荧光联合染料染色在乳腺癌前哨淋巴结活检中的应用研究[J].中国综合临床,2015, 31(12):1067-1070. doi:10.3760/cma. j. issn.1008-6315.2015.12.004.
[6]黄海燕,黄爱民,高美钦.生存素与Ki67在乳腺癌的表达及临床病理意义[J].福建医科大学学报, 2006, 40(2):143-146.
[7]李宝江,朱志华,王军业,等. Ki67、p53、VEGF和C-erb B-2在乳腺癌组织中表达的相关性研究及其临床意义[J].癌症, 2004, 23(10):1176-1179. doi:10.3969/j.issn.1000-467X.2004.10.014.
[8]Trihia H, Murray S, Price K, et al. Ki-67 expression in breast carcinoma:its association with grading systems, clinical parameters, and other prognostic factors--a surrogate marker?[J]. Cancer, 2003, 97(5):1321-1331. doi:10.1002/cncr.11188.
[9]白晓蓉,杨碎胜,高晨.人表皮生长因子受体-2和细胞增殖抗原Ki67与乳腺癌前哨淋巴结转移的关系分析[J].中国实用医药, 2018, 13(6):8-9. doi:10.14163/j.cnki.11-5547/r.2018.06.004.
[10]杨丽,张春霞,王文超,等.人表皮生长因子受体-2和细胞增殖抗原Ki67与乳腺癌前哨淋巴结转移的关系[J].中华实用诊断与治疗杂志, 2016, 30(2):163-165. doi:10.13507/j. issn.1674-3474.2016.02.019.
[11]徐宇,朱蕙燕,陈勇,等.前哨淋巴结活检在中国皮肤和肢端恶性黑色素瘤患者诊治中的临床意义[J].中国癌症杂志, 2018, 28(11):819-826. doi:10.19401/j. cnki.1007-3639.2018.11.004.
[12]李晴,马晓欣.前哨淋巴结在妇科恶性肿瘤中的研究及应用[J].国际妇产科学杂志, 2018, 45(6):628-633.
[13]沈镇宙,柳光宇,杨帆.见微知著——腋窝淋巴结与前哨淋巴结活检[J].医学与哲学(B), 2018, 39(11):18-20.
[14]Bediaga NG, Beristain E, Calvo B, et al. Luminal B breast cancer subtype displays a dicotomic epigenetic pattern[J]. Springerplus, 2016, 5:623. doi:10.1186/s40064-016-2235-0.
[15]Soliman NA, Yussif SM. Ki-67 as a prognostic marker according to breast cancer molecular subtype[J]. Cancer Biol Med, 2016, 13(4):496-504. doi:10.20892/j. issn.2095-3941.2016.0066.
[16]袁琳,周文辉,赵卫卫,等. Ki-67在乳腺癌组织中的表达及其临床意义研究[J].国际检验医学杂志, 2017, 38(11):1464-1467. doi:10.3969/j. issn.1673-4130.2017.11.009.
[17]Ohara M, Matsuura K, Akimoto E, et al. Prognostic value of Ki67 and p53 in patients with estrogen receptor-positive and human epidermal growth factor receptor 2-negative breast cancer:Validation of the cut-off value of the Ki67 labeling index as a predictive factor[J]. Mol Clin Oncol, 2016,4(4):648-654. doi:10.3892/mco.2016.776.
[18]焦得闯,乔江华,卢振铎,等.早期乳腺癌前哨淋巴结阳性预测因素分析[J].中华肿瘤杂志, 2014, 36(3):198-201.doi:10.3760/cma. j. issn.0253-3766.2014.03.008.
[19]王慧,王靖,高纪东,等.乳腺癌前哨淋巴结和非前哨淋巴结转移的影响因素分析[J].中华肿瘤杂志, 2013,35(10):769-772. doi:10.3760/cma. j. issn.0253-3766.2013.10.011.