层粘连蛋白及其受体在乳腺癌的表达与转移和预后的关系

目的观察层粘连蛋白（ｌａｍｉｎｉｎ,ＬＮ）和层粘连蛋白受体（ｌａｍｉｎｉｎｒｅｃｅｐｔｏｒ,ＬＮ－Ｒ）与乳腺癌转移和预后的关系。方法用ＬＳＡＢ免疫组化法,检测了１０９例乳腺癌原发灶和３７例淋巴结转移灶组织中ＬＮ和ＬＮ－Ｒ在癌细胞内表达的情况。结果有３２例（２９．４％）原发灶浸润性癌细胞内可见ＬＮ表达,５例（１３．７％）腋窝淋巴结转移灶中癌细胞内有ＬＮ表达。乳腺癌原发灶中有ＬＮ－Ｒ表达者占５５．０４％,淋巴结转移灶中ＬＮ－Ｒ表达占８３．７８％,后者明显高于前者（Ｐ＜０．０５）。６４例随访材料中单独ＬＮ表达者无１例死亡,而有ＬＮ－Ｒ表达者生存期明显短于无ＬＮ－Ｒ表达者（Ｐ＜０．００１）。经临床和病理多因素比例风险回归分析,显示淋巴结转移和ＬＮ－Ｒ是影响患者生存的独立因素,ＬＮ－Ｒ的风险度（４．３７５倍）大于淋巴结转移（２．８１０倍）。结论结果提示ＬＮ－Ｒ表达是导致乳腺癌患者死亡的重要生物学因素之一。

The relationship between laminin and laminin receptor expression to metastasis and survival of breast carcinomas

Objective To investigate the relationship between laminin (LN) and LN receptor (LN R) expression to breast carcinoma metastasis and survival. Method The LSAB immunohistochemical method was used to study cytoplasm of primary breast cancer tissue from 109 cases and 37 axillary lymph nodes with metastasis. Results Immunostaining of LN was detected in 32 (29.4%) primary breast carcinoma and in 5 (13.7%) axillary nodes with metastasis. The expression of LN R was significantly lower in primary breast carcinomas (55.0%) than in the node positive tissues (83.8%) ( P <0.05). Among the 64 cases followed up none of the 6 patients with LN positive alone died after 3 years. Whereas, the LN R positive (including LN R positive alone or both LN and LN R positive) cases had a significantly poorer prognosis when compared with the LN R negative cases ( P <0.001). Multivariate analysis of clinical and pathological data by Cox regression method demonstrated that both LN R expression and lymph node status were independent factors affecting the survival of breast cancer patients, but the former had a higher risk (odds ratio=4.375) than the latter (OR=2.810). Conclusion These results suggest that LN R expression is an important biofactor for predicting the prognosis of breast cancer.