CK5/6在乳腺癌组织中的表达与临床病理特征相关性

目的:探讨肿瘤组织中CK5/6的分布特点及其与乳腺癌的组织学分级、肿瘤大小、腋窝淋巴结转移、雌孕激素受体的关系,为乳腺癌的临床诊断、指导临床治疗及预后提供重要依据.方法:病理取材及苏木精伊红(HE)染色；利用免疫组化法检测175例浸润性乳腺癌组织CK5/6的表达情况.结果:①175例乳腺癌组织中CK5/6(+)表达为17.7％,CK5/6(-)表达为82.3％.②CK5/6的表达与患者是否绝经、肿瘤的大小、组织学分级和淋巴结转移与否之间无统计学意义(P＞0.05)；但在淋巴结转移的患者中淋巴结转移＜4枚与淋巴结≥4枚的患者间比较,CK5/6的表达具有统计学意义(P＜0.05).③CK5/6的表达与ER、PR结果之间比较,具有统计学意义(P＜0.01),在ER( -)、PR(-)的患者中,CK5/6的表达阳性率高；患者的HER2(-)与HER2(+)、HER2(++)以及HER2(+)与HER2(++)、HER2(+++)之间比较,无统计学意义(P＞0.05),但HER2(-)与HER2(+++),HER2(++)与HER2(+++)之间比较,差异具有统计学意义(P＜0.05).④CK5/6在26例ER、PR和HER2阴性乳腺癌(三阴性乳腺癌)的表达率为65.2％,在136例非三阴性乳腺癌的表达率为11.2％,两者之间差异具有明显统计学意义(P＜0.01).结论:①CK5/6在乳腺癌中的表达与患者月经状态、肿瘤大小、组织学分级和淋巴结累及情况均无明确关联性.②CK5/6在ER、PR阴性乳腺癌患者中的表达明显增高.CK5/6在HER2强阳性乳腺癌患者中的表达明显高于HER2阴性患者,可能与乳腺癌侵袭、转移和预后存在关联性.③CK5/6的表达与乳腺癌腋窝淋巴结累及情况无关,但随着淋巴结转移数量的增加,其阳性表达率明显增高.④CK5/6在三阴性乳腺癌中的阳性表达率明显高于非三阴性乳腺癌,可以较准确地进行分子分型,更好地指导临床治疗及预测患者的预后.

The Correlation Investigation of CK5/6 and EGFR Expression in Breast Cancer and Clinical Pathological Features

Objective:To investigate their distribution characteristic in the breast cancer and its relationship with the breast cancer histological grade,tumor size,axillary lymph node metastasis,estrogen and progesterone receptors.Provide an important basis on diagnosis,clinical treatment and prognosis of the breast cancer.Methods:Material taking and hematoxylin and eosin(HE) staining: hematoxylin and eosin stain.Detect the expression of CK5/6 in 175 cases of infitrating ductal carcinoma in the method of immunohistochemistry.Results:①The positive rate of CK5/6 is 17.7% in 175 cases of breast cancer tissues,the negative rate is 82.3%.②The relationship between the expression of CK5/6 and menopause,tumor size,pathological grade,lymph node metastasis is not statistically significant(P>0.05),but the comparation of axillary lymph node metastasis is less than 4 and greater than or equal to 4 is significant difference(P<0.05).③The comparison between CK5/6 expression and the ER,PR results is statistical difference(P<0.01).In the patients of ER(-),PR(-),the CK5/6 positive expression rate is high.There is no significant difference(p>0.05) in the comparison among HER2(-),HER2(+) and HER2(++) and the comparison among HER2(+),HER2(++)and HER2(+++).However there are significant differences(P<0.05) in the comparison between HER2(-) and HER2(+++),and the comparison between HER2(++) and HER2(+++).There is no difference(P>0.05) in the comparison between EGFR expression and ER,PR results,In the patients of ER(-),PR(-),the EGFR expression was lower,There is no significantly difference(P>0.05) in comparison between the patients with HER2(-) and HER2(+),HER2(+) and HER2(+++),HER2(++) and HER2(+++).however,there is statistical difference(P<0.05)in the comparison among HER2(-) and HER2(++),HER2(+++),HER2(+) and HER2(++).④The CK5/6 expression rate in 26 cases of ER,PR and HER2 negative(triple-negative) breast cancer is 65.2%,the rate in 136 cases of patients with non three negative is 11.2%.the difference between the two is clear statistical significance(P<0.01).Conclusion:①The expressions of CK5/6 in breast cancer tissue are not related to menopause,tumor size,pathological grade,lymph node status.②There are high positive rates of CK5/6 in ER and PR negative breast cancer,but the expressions of EGFR are not related to ER and PR status.The expressions of CK5/6 in HER2 high positive breasr cancer are more than in the HER2 negative breast cancer.That suggest the expression of CK5/6 is correlate to the invasion,metastasis and prognosis of breast cancer.③The expressions of CK5/6 in breast cancer are not related to lymph node status,but there are high positive rates in more axillary lymph node metastasis.④The positive rate of CK5/6 expression in triple-negative breast cancer is significantly higher than non triple-negative breast cancer,that can make molecular typing more accuratly,and direct the clinical treatment and predict prognosis.