乳腺癌ER、PR、p53、Her-2表达与新辅助化疗有效率的关系

目的探讨乳腺癌患者ER、PR、p53、Her-2的表达及其与新辅助化疗有效率的关系。方法采用免疫组化的方法检测178例乳腺癌新辅助化疗患者化疗前ER、PR、p53、Her-2的表达情况,观察新辅助化疗的效果。结果178例乳腺癌新辅助化疗病例中,ER、PR、p53阴性率、Her-2过度表达率分别为33.15、23.60%、60.67%、35.39%。ER(+)组与ER(-)组、PR(+)组与PR(-)组、p53(+)组与p53(-)组化疗有效率差异均有统计学意义(P<0.05),Her-2过度表达组与非过度表达组化疗有效率差异无统计学意义(P>0.05)。结论ER、PR、p53阴性的乳腺癌病人对化疗更敏感,化疗后获益更多,ER、PR、p53可作为乳腺癌新辅助化疗(TE或CET方案)敏感性的预测指标。     

乳癌p53与雌、孕激素受体的表达及临床意义

目的 探讨乳癌p53与雌、孕激素受体的表达及其临床意义。方法 应用免疫组化技术PAP法，测定200例乳癌的p53与雌、孕激素受体。结果 p53( )，雌激素受体（ER）（＋），孕激素受体（PR）（＋）分别为34.0%,63.0%和64.0%。ER（＋）及PR（＋）共96例，ER（－）及PR（－）共35例，ER和PR表达一致率为79.0%。显示上述三指标的阳性表达与病人腋淋巴结转移、病理组织类型无关，但与病人年龄、月经状况有关。结论 乳癌p53阳性预后差，ER及PR阳性比阴性的患者预后好，p53，ER和PR测定有助于指导乳癌的临床治疗和判断预后。     

激素受体表达在乳腺癌空芯针穿刺与手术切除标本符合率的研究

目的 :探讨雌激素受体(estrogen receptor,ER)、孕激素受体(progesterone receptor,PR)和Her-2在乳腺癌空芯针穿刺(core needle biopsy,CNB)标本与手术切除标本的表达和符合率。方法:本研究为我院接受乳腺癌手术治疗、术前行CNB检测的病人,对配对的CNB和手术切除标本进行ER、PR和Her-2表达的检测,比较其结果和符合率。结果:136例乳腺癌病人ER、PR和Her-2的阳性率分别为78.7%、61.8%和22.1%,与手术切除标本的77.9%、64.7%和20.6%相比较,无统计学差异(P>0.05)。ER、PR和Her-2在CNB与手术切除标本的符合率分别为96.3%、86.8%和98.5%,κ值均>0.6(P     

生长抑素受体和雌激素受体在原发性乳腺癌中的表达及其意义

目的研究生长抑素受体(SSTR)与雌激素受体(ER)、孕激素受体(PR)在原发性乳腺癌中的表达及其意义。方法 采用免疫组织化学链霉菌抗生物素蛋白-过氧化酶(SP)法检测SSTR和ER、PR在68例乳腺癌中的表达。结果 在68例乳腺癌中,SSTR阳性表达44例(64.70％),ER、PR阳性表达51例(75.70％),ER、PR和SSTR同时阳性表达阳性41例(60.29％)。ER、PR和SSTR两者表达呈正相关(r=0.651 6,P<0.05)。SSTR阳性患者复发率和死亡率低于SSTR阴性者(P<0.05);SSTR阳性且ER、PR阳性患者复发率和死亡率明显低于SSTR阴性ER、PR阴性患者(P<0.01)。病理分化低的有47例,SSTR阳性表达36例(P>0.05)。结论SSTR表达与ER、PR表达有明显相关性,有可能作为判断乳腺癌预后的指标。     

乳腺不典型增生和乳腺癌中p53、ER表达的意义

目的探讨p53基因产物和雌激素受体(ER)在乳腺不典型增生和乳腺癌中表达及意义。方法用ABC免疫组化法检测乳腺不典型增生和乳腺癌细胞p53基因产物和ER表达。结果乳腺上皮不典型增生Ⅰ级者上皮细胞ER染色结果与正常乳腺上皮细胞相似，不典型增生Ⅱ级ER表达明显增强，22／24例阳性，不典型增生Ⅲ级20／22例见ER染色阳性。在乳腺上皮不典型增生Ⅰ级无p53蛋白表达，不典型增生Ⅱ级、Ⅲ级中分别有3／24和7／22例p53蛋白表达。乳腺癌59例，ER阳性率为36／59(61．02％)。乳腺癌p53蛋白表达阳性22／59(37．29％)。结论p53可促进正常细胞以不典型增生向癌的转化，ER对不典型增生癌变起重要的刺激、激活作用。p53-／ER 代表正常组织、良性增生与高分化和好的预后，p53 ／ER-多为不典型增生、低分化癌和差的预后。所以同时检测p53、ER对判断不典型增生向癌的转化及乳腺癌患者的预后有重要意义。     

雌、孕激素受体和p53,p21 蛋白在胆囊癌中的表达及其相互关系

目的 探讨雌激素受体（ER），孕激素受体（PR）和p53,p21在胆囊癌的发生发展中的生物学意义及其相互关系。方法 采用即用型一抗加nvision微波加热免疫组化法对12例胆囊癌进行ER，PR和p53,p21表达及分析。结果 （1）胆囊癌细胞内存在ER，PR，其阳性表达率分别为83．3％和75．0％；（2）胆囊癌p53,p21阳性表达率均为66．6％，ER，PR与p53,p21阳性表达一致率为58．3％；（3）癌细胞分化越差，浸润越深，ER，PR和p53,p21阳性表达率越高。结论 ER，PR和p53,p21阳性表达与胆囊癌的分化程度和浸润深度有关，这对运用内分泌治疗的疗效观察及预后判断有重要意义。ER，PR过度表达可能会诱发p53,p21基因突变，两者在胆囊癌的发生发展中有着密切的内在联系。     

雌、孕激素受体和表皮生长因子受体2在乳腺癌分型中的应用

目的 研究乳腺癌分子亚型的临床病理特征及预后.方法 SP法检测509例手术切除的乳腺癌雌激素受体(estrogen receptor,ER)、孕激素受体(progesterone receptor,PR)、表皮生长因子受体2(erbB-2,Her-2)表达并对其分型,Her-2-、ER/PR+为腔上皮样A亚型(Luminal A),Her-2+、ER/PR+为腔上皮样B亚型(Luminal B),Her-2-、ER-、PR-为三阴性型(Tripie-negative)、Her-2+、ER-、PR-为ERBB2+亚型(ERBB2+).χ~2检验比较亚型的临床病理特征,Kaplan-Meier法分析5年无瘤生存率(DFS),单因素和Cox多因素分析与复发和转移相关的因素.结果 Luminal A占所有病例40.5%(206/509),Luminal B占18.5%(94/509),Tripie-negative占21.4%(109/509),ERBB2+19.6%(100/509).三阴性型乳腺癌中髓样癌的比例高于其他类型乳腺癌(P<0.05),4种亚型复发转移率差异有统计学意义(P=0.029).多因素分析发现淋巴结状态和l临床分期是独立的预后影响因素(P=0.000).ERBB2+和Triple-negative的DFS分别为81%、78.9%,低于Luminal A和Luminal B的DFS(88.8%、90.4%)(P=0.025).结论 在本组乳腺癌患者中,Luminal A亚型所占比例最高,Triple-negative和ERBB2+复发转移率高,预后较Luminal A和Luminal B亚型差.     

Her-2阴性乳腺癌中激素受体、Ki-67、P53的表达与蒽环类新辅助化疗疗效的关系

目的探讨Her-2阴性乳腺癌中激素受体、Ki-67、P53的表达与蒽环类新辅助化疗疗效的关系。方法应用免疫组化法测定78例Her-2阴性乳腺浸润性导管癌蒽环类新辅助化疗前ER、PR、Ki-67、P53的表达。四个周期CEF或AC方案化疗后进行临床及病理疗效评价。结果激素受体双阳或单阳组与激素受体双阴组相比,临床总有效率及术后病理有效率有显著性差异(P0.05);Ki-67阳性组与Ki-67阴性组相比,临床总有效率无显著性差异(P0.05),术后病理有效率有显著性差异(P0.05);P53阳性组与P53阴性组相比,临床总有效率及术后病理有效率均未见显著性差异(P10.05)。结论激素受体阴性、Ki-67阳性对Her-2阴性乳腺癌患者蒽环类新辅助化疗的敏感性较高,激素受体状态、Ki-67可能成为判断Her-2阴性乳腺癌蒽环类新辅助化疗疗效的重要指标。     

乳腺浸润性导管癌中ER, PR, c-erbB-2, p53和nm23的表达及对预后的多因素分析

应用免疫组化S-P法检测78例乳腺浸润性导管癌组织中ER, PR, c-erbB-2, p53和nm23蛋白的表达，以Cox模型分析影响其预后的临床病理和生物学指标。结果示ER, PR, c-erbB-2, p53和nm23蛋白阳性表达率分别为44.9%, 39.7%, 67.9%, 51.3%和69.2%。ER表达与年龄、月经状况、组织学分级有关;PR和c-erbB-2表达仅与组织学分级有关;p53表达仅与年龄有关;nm23表达与肿瘤大小、TNM分期、3年生存率有关。多因素Cox回归分析显示：患病年龄、TNM分期和组织学分级的危险度分别为3.574, 31.661和2.019。提示：患病年龄、TNM分期和组织学分级等临床病理学指标能反映乳腺浸润性导管癌的预后情况;同时参考上述5种生物学指标，有助于评估预后。     

趋化因子受体5表达与乳腺癌临床病理特征及预后的相关性研究

目的 探讨趋化因子受体5(CCR5)在乳腺癌病灶和腋窝转移淋巴结中的表达及其与临床病理意义.方法 收集72例乳腺导管浸润癌及其腋窝淋巴结组织,50例乳腺纤维腺瘤组织,40例正常乳腺组织石蜡标本切片.采用免疫组化方法检测CCR5的表达情况;同时检测乳腺癌组织中C-erbB-2,p53,Ki-67,ER,PR的表达情况,并与临床病理资料进行统计学分析.结果 (1)乳腺癌组织中CCR5蛋白表达阳性率达84.72%(61/72),乳腺纤维腺瘤组织中表达阳性率较低(14%,7/50),正常乳腺组织中不表达CCR5;(2)乳腺癌CCR5表达与腋窝淋巴结转移呈正相关(X<'2>=4.982,P=0.026,r=0.305);(3)50例伴腋窝淋巴结转移的患者中,乳腺癌原发灶及转移淋巴结同时表达CCR5阳性者39例,具有较高的同源性;(4)乳腺癌CCR5表达与癌基因C-erbB-2之间呈低度正相关(P<0.05,r=0.291);(5)乳腺癌CCR5表达与患者年龄、绝经与否、肿瘤最大径、肿瘤分期等临床特征无关(均P>0.05);(6)乳腺癌CCR5表达与p53,Ki-67,ER,PR无关表达(均P>0.05).结论 CCR5在乳腺癌的发生、发展及腋窝淋巴结转移方面起一定作用;CCR5可间接作为预测乳腺癌腋窝淋巴结转移及预后判断的指标之一.     

乳腺癌病理生物学特性与多肿瘤基因表达的关系

目的 观察多肿瘤基因在乳腺癌组织中的表达,探讨其与乳腺癌病理生物学特性的关系.方法 采用免疫组织化学SP染色法对120例乳腺癌组织中多肿瘤基因的表达进行检测[雌激素受体(ER)、孕激素受体(PR)、表皮生长因子受体(C-erB-2)、p53、转移抑制基因(mn23)、bcl-2、增殖细胞核抗原(PCNA)、多药耐药蛋白(MRP)],分析其与乳腺癌病理生物学特性的关系.结果 p53、bcl-2的表达在不同乳腺癌激素受体状态中差异有统计学意义,且与ER、PR的表达有显著相关性:p53在ER(-)、PR(-)的乳腺癌中呈现高表达,在ER(+)、PR(+)的乳腺癌中呈现低表达(P<0.01);而bcl-2则相反(P<0.01).bcl-2的表达与月经状态有关,在绝经前乳腺癌组织中的表达明显高于绝经后乳腺癌(P<0.01).PCNA的表达与肿瘤的大小相关,在直径较大的肿瘤(>3 cm)中的表达显著高于直径较小的肿瘤(≤3 cm,P<0.01).结论 p53、bcl-2的表达与ER、PR的状态相关,可作为判断乳腺癌生物学特性和预后的重要指标.     

Molecular breast cancer subtypes in premenopausal and postmenopausal African-American women: age-specific prevalence and survival

BACKGROUND: Breast cancer is currently regarded as a heterogeneous disease classified into various molecular subtypes using gene expression analysis. These molecular subtypes include: basal cell-like, Her-2/neu, luminal A, and luminal B. OBJECTIVES: To analyze the prevalence and clinicopathologic associations for molecular breast cancer subtypes in premenopausal and postmenopausal African-American women. DESIGN: A retrospective analysis of all African-American women diagnosed with breast cancer from 1998 to 2005, who had assessable data for ER, PR, and Her-2/neu status. Molecular subtype classification was done based on immunohistochemical surrogates for ER, PR, and Her-2/neu status obtained from Howard University tumor registry for each patient. The molecular subtypes were defined as: luminal A (ER+ and/or PR+, HER2-), luminal B (ER+ and/or PR+, HER2+), basal-like (ER-, PR-, HER2-), and Her-2/neu (ER-, PR-, and HER2+). OUTCOME MEASURES: We analyzed the prevalence of molecular breast cancer subtypes in a population of African-American women and determined their associations with patient demographics and clinicopathologic variables: node status, tumor size, histological grade, p53 mutation status, and breast cancer-specific survival. RESULTS: The luminal A subtype was the most prevalent in our study sample (55.4%) compared with (11.8%) luminal B, (21.2%) basal cell-like, and (11.6%) Her-2/neu subtypes. The molecular subtypes did not differ by menopausal status. However, when stratified into age-specific groups, the basal cell-like subtype (57.1%) was the most prevalent in the age group <35 y compared with luminal A, luminal B, and Her-2/neu subtypes at 25.0%, 14.3%, and 3.6%, respectively. The basal cell-like subtype also showed an age-specific bimodal distribution with a peak in the <35 y and 51 to 65 y age groups. The basal cell-like and the Her-2/neu subtypes showed an increased association with clinicopathologic variables portending a more aggressive clinical course when compared with luminal A subtype. A paradoxical inverse relationship between the expression of p53 and Bcl-2 protooncoprotein was noted in the molecular subtypes. Breast cancer-specific survival differed significantly among the molecular subtypes (P < 0.04), with the basal cell-like and Her-2/neu subtypes having the poorest outcome. CONCLUSIONS: The high prevalence of the basal cell-like subtype in the young premenopausal African-American women aged <35 y could be a contributory factor to the poorer prognosis of breast cancer observed in this cohort of patients.     

Ki-67在T1期乳腺癌中的表达及其与Her-2和ER的关系

目的 研究Ki-67在T1期乳腺癌的表达情况,以及其与雌激素受体(ER)、人表皮生长因子受体-2(Her-2)的关系,指导早期乳腺癌的预后判断.方法 选择2008年1月至2011年6月的女性新发T1期乳腺癌组织共60例,免疫组化检测Ki-67的表达情况,并分析其表达与临床病理特征和Her-2、ER表达的关系.结果 60...     

Correlation of her-2/neu gene amplification with other prognostic and predictive factors in female breast carcinoma

The purpose of this study was to determine if any relationship exists between Her-2/neu gene amplification and estrogen receptor (ER), progesterone receptor (PR), MIB-1, grade, size and age in female breast cancer. Five hundred and eighteen female patients with invasive breast carcinoma, 390 ductal and 128 lobular, in which assessment of Her-2/neu amplification by fluorescence in-situ hybridization (FISH) has been performed, were reviewed retrospectively. Each patient was further assessed for ER, PR, MIB-1, grade, size and age at diagnosis. Chi-square analysis was then used to correlate the above observations. Overall gene amplification was seen in 76 (15%) of the cases, 68 (17%) were ductal and 8 (6%) were lobular. Her-2/neu gene was amplified in 37 (10%) out of 379 ER positive cases and in 39 (28%) out of 139 ER negative cases. Her-2/neu was amplified in 22 (7%) out of 301 PR positive cases and in 54 (25%) out of 217 PR negative cases. Amplification occurred in 18 (8%) out of 222 negative MIB-1 cases and amplified in 58 (20%) out of 296 positive cases. Amplification was seen in 5 (10%) out of 49 grade I tumors, 17 (12%) out of 143 grade II tumors and 54 (27%) out of 198 grade III tumors. Lobular carcinomas were not graded. Amplification was present in 52 (15%) out of 346 T1 lesions, in 17 (13%) out of 130 T2 lesions, in 5 (17%) out of 30 T3 lesions and in 2 (17%) out of 12 T4 lesions. Her-2/neu was amplified in 67 (14%) out of 467 woman 41 years and older, and in 9 (18%) out of 51 women 40 years and younger. Comparison of these frequencies using chi-square test revealed statistically significant correlation between Her-2/neu amplification and ductal versus lobular carcinoma (p<0.0003), ER (p=0.0001) and PR (p<0.0001) negative tumors, over-expression of MIB-1 (p<0.0005) and high tumor grade (p=0.0009), while size of the tumor (p=0.08) and age of the patients (p=0.67) were not statistically significant. Correlation was found between Her-2/neu amplification and tumor type, high histological grade, ER and PR negative tumors, and high proliferative MIB-1 index. No correlation was found between size of the tumor and age of the patient with Her-2/neu amplification.     

ER、PR、p53、c—erbB-2在乳腺囊性增生病中的表达意义

目的：研究乳腺囊性增生病中雌激素受体（ER）、孕激素受体（PR）、p53和c—erbB-2表达的临床意义。方法：用免疫组化SP法检测62例乳腺囊性增生病中ER、PR、p53和c—erbB-2表达分布情况。结果：62例患者中ER阴性6例,占10％;阳性56例,占90％。PR阴性7例,占11％;阳性55例,占89％。p53阴性35例,占57％;阳性27例,占43％。c—erbB-2阴性41例,占66％;阳性21例,占34％。结论：乳腺囊性增生病的发生与ER、PR有关,其病变发展与c—erbB-2和p53关系密切,同时也是检测是否癌变的一种实用可靠的方法。     

Ki-67、P53在Her-2阴性乳腺癌中的表达与ER、腋窝淋巴结转移相关性

目的观察Ki-67、P53在Her-2阴性乳腺癌组织中的表达与ER及腋窝淋巴结转移相关性,探讨其临床意义,提示乳腺癌预后。方法 202例Her-2阴性乳腺患者,根据ER表达情况,将患者分为ER阴性组和ER阳性组,其中ER阴性组99例,ER阳性组103例,研究Ki-67、P53在Her-2阴性乳腺癌组织中的表达与ER及腋窝淋巴结转移相关性。结果 Her-2阴性乳腺癌组织中Ki-67增殖指数在ER阴性组表达明显高于ER阳性组,差异有统计学意义(P0.05),Ki-67增殖指数在腋窝淋巴结阳性组明显高于淋巴结阴性组,差异有统计学意义(P0.05)。P53在ER阴性组表达明显高于ER阳性组,差异有统计学意义(P0.05),P53表达在腋窝淋巴结阳性组和阴性组差异无统计学意义(P0.05)。结论 Her-2阴性乳腺癌组织中Ki-67增殖指数与ER阴性表达正相关,且腋窝淋巴结转移可能性大,P53与ER阴性表达正相关,与腋窝淋巴结转移无明显相关。提示Ki-67、P53可能为Her-2阴性乳腺癌的不良预后因素。     

酪氨酸激酶Syk基因在乳腺癌组织中的表达及其临床意义

目的　探讨酪氨酸激酶Syk基因表达与乳腺癌生成及转移的关系 ,以及与雌激素受体(ER)、孕激素受体 (PR)、p5 3、HER2 /neu基因的关系。方法　用半定量逆转录聚合酶链反应检测 4 0例乳腺癌患者癌组织及癌旁正常乳腺组织以及 15例良性乳房纤维瘤组织中SykmRNA的表达 ,并用免疫组化方法检测 4 0例乳腺癌组织中ER、PR、p5 3、HER2 /neu的表达的情况。结果　所有正常乳腺组织都有Syk基因的表达 ,而 4 0例乳腺癌组织中只有 9例表达 ,正常乳腺与乳腺癌组织中Syk基因表达率差异有显著意义 (χ2 =4 7 4 ,P <0 0 5 ) ,且乳腺癌组织中SykmRNA含量明显低于正常乳腺组织 (t =3 4 1,P <0 0 5 )。有淋巴结转移的 18例乳腺癌组织中 ,1例有Syk基因表达 ,有淋巴结转移的乳腺癌SykmRNA的表达率和表达水平显著降低 (χ2 =3 77,P <0 0 5 ,t=2 74 ,P <0 0 5 )。SykmRNA表达与 p5 3基因的表达呈正相关。 结论　Syk基因的表达在抑制乳腺癌的生长及转移过程中可能起着重要的作用     

Comparison of estrogen receptor, progesterone receptor and Her-2 status in breast cancer pre- and post-neoadjuvant chemotherapy

Neoadjuvant chemotherapy (NAC) is now a relatively standard treatment for breast carcinoma. However, some tumors are known to develop resistance to chemotherapies. We investigated whether the status of estrogen receptor (ER), progesterone receptor (PR) and Her-2 expressions in breast cancer cases prior to NAC could be changed after NAC. We used immunohistochemistry (IHC) and fluorescence in situ hybridization (FISH) methods. No differences were found in ER or Her-2 status, but a significant difference was found in PR status. Changes in Her-2 status were suspected in four specimens after NAC (3+ to 1+ for 3 patients, and 1+ to 3+ for one patient) according to the IHC results. However, in all four of these cases, FISH of the resections showed no change. When IHC indicates a change in Her-2 expression after NAC, FISH is recommended.     

The utility of estrogen receptor, progesterone receptor, and Her-2/neu status to predict survival in patients undergoing hepatic resection for breast cancer metastases

BACKGROUND: Hepatic metastases from breast cancer signal a dismal prognosis, with a median survival of 9.5 months. METHODS: Twenty breast cancer patients with liver metastases underwent hepatic resection, biopsy, or ablation between 1995 and 2004. Hormone receptor status and Her-2/neu expression of primary and metastatic tumors were correlated with overall survival. RESULTS: At a mean follow-up of 39 months after hepatic resection, median survival was 32 months. Patients undergoing anatomic resection with or without ablation lived significantly longer than those undergoing more limited resections (46 vs. 25 months, P = .016). Survival was significantly greater in patients with estrogen receptor (ER)-positive primary (P = .02) and metastatic (P < .004) tumors, Her-2/neu-positive metastases (P = .02), 50 years at metastasectomy (P = .02). CONCLUSIONS: The ER status of the primary tumor and ER and Her-2/neu status of hepatic metastases, in addition to other clinical factors, may help select patients who would benefit from hepatic metastasectomy.