MCM4与c-erbB-2蛋白在乳腺浸润性导管癌组织中的表达及其临床意义

目的检测MCM4、C—erbB-2蛋白在乳腺浸润性导管癌（IDC）组织中表达的改变及其在癌发生、发展中的作用。方法采用免疫组化SP法检测80例IDC、20例乳腺不典型增生和30例乳腺腺病等非癌病变旁正常乳腺组织中MCM4、c-erbB-2蛋白的表达情况。结果80例IDC、20例不典型增生组织中MCM4蛋白的阳性率分别为86．25％、70％，与正常对照组比较差异极显著（P〈0．01）。IDC组织中c—erbB-2蛋白的阳性率为65％，与不典型增生组及正常对照组比较差异显著（P〈0．05）。乳腺癌组中MCM4蛋白的阳性表达与组织学分级、TNM分期、淋巴结转移及肿瘤大小有关（P〈0．05），与年龄无关。c-erbB-2蛋白的阳性表达与淋巴结转移有关（P〈0．05），而与组织学分级、TNM分期、肿瘤大小及年龄无关。MCM4蛋白的阳性表达与c—erbB-2的表达呈正相关（r=O．240，P〈0．05）。结论MCM4蛋白阳性表达可作为乳腺癌发生、发展的生物学指标，联合c-erbB-2检测有助于乳腺癌预后的判断及I临床治疗的指导。

Expression and clinical significances of MCM4 and c-erbB-2 protein in breast invasive ductal carcinoma

Objective To evaluate the significance of MCM4 and c-erbB-2 protein expression and the correlations with carcinogenesis and progression in breast invasive ductal carcinoma. Methods The SP immunohistochemical technique was used to detect the expression of MCM4 and c-erbB-2 in 80 cases of breast invasive ductal carcinoma, 20 cases of atypical hyperplasia and 30 cases of normal breast tissues of non-cancerous breast disease. Results The positive rates of MCM4 in 80 cases of breast invasive ductal carcinoma and 20 atypical hyperplasia were 86.25% (69/80) and 70.00% (14/20) respectively, which were significantly higher than those in normal breast tissues (P＜0.001). The positivity rate of c-erbB-2 in breast invasive ductal carcinoma was 65.00% (52/80), which was significantly higher than those in atypical hyperplasia and normal breast tissues (P＜0.05). In breast invasive ductal carcinoma, MCM4 protein positive expression was associated with histological grading, clinical stage, lymph node status and tumor size (P＜0.05), but no correlation with age (P＞0.05). C-erbB-2 positive expression was associated with lymph node status (P＜0.05) , and no correlation with histological grading, clinical stage, tumor size and age (P＞0.05). There was positive correlation between the expression of MCM4 and c-erbB-2 (r=0.240, P＜0.05). Conclusion The expression of MCM4 protein is an objective biologic marker for estimating the occurrence and progression of breast cancer. Combined detection of MCM4 and c-erbB-2 may help judge the prognosis and guide clinical treatment of breast cancer.