不同分子亚型浸润性乳腺癌中p53基因及Ki-67抗原的表达及意义

目的探讨p53基因及Ki-67抗原在不同分子亚型浸润性乳腺癌中的表达及意义。方法采用免疫组化法检测275例浸润性乳腺癌组织中雌激素受体（ER）、孕激素受体（PR）、人表皮生长因子受体2（HER-2）、p53基因及Ki-67抗原的表达水平。结果p53在激素受体阳性组（175例）、HER-2受体阳性组（60例）、三阴性乳腺癌组（40例）中的表达率分别为29．7％，55．0％和75．0％，三组间差异有统计学意义（χ^2=32．924，P〈0．05），以三阴性组表达最高。Ki-67在激素受体阳性组、HER-2受体阳性组、三阴性乳腺癌组中的表达率分别为74．3％，95．0％和95．0％，三组间差异有统计学意义（χ^2=18．355，P〈0．05），以三阴性组和HER2阳性组表达最高。p53基因和Ki-67抗原的表达阳性率在有腋窝淋巴结转移的乳腺癌组中高于无腋窝淋巴结转移组，差异有统计学意义（χ^2=5．257，P〈0．05；χ^2=12．664，P〈0．05）。结论在乳腺癌的分子亚型中联合检测p53基因及Ki-67抗原可以作为乳腺癌发生、发展的评价指标，更有助于指导其临床治疗和判断预后。

The expression and significance of p53 and Ki-67 in different molecular subtypes of breast carcinoma

Objective To investigate the expression of p53 and Ki-67 in different molecular subtypes of breast carcinoma and the significance thereof. Methods The expression of ER,PR,HER2 ,p53 and Ki-67 were detected immunohistochemically in 275 specimens of invasive breast carcinoma Results Based on immunohistochemical staining, the rates of p53 expression were 29.7% in ER/PR （ ＋ ） group, 55.0% in HER2（ ＋ ）group, and 75.0% in triple negative breast cancer group. Significant differences were found among 3 groups （ χ^2 = 32. 924, P 〈 0. 05 ） , with the highest expression level in triple negative breast cancer group. Accordingly, the rates of Ki-67 expression were 74. 3% in ER/PR（ ＋ ）group,95.0% in HER2 （ ＋ ） group and 95.0% in triple negative breast cancer group. Significant differences existed between 3 groups （χ^2 = 18. 355, P 〈0. 05）. We also found the higher expression level in HER2 （ ＋ ）group and the triple negative breast cancer group. We also demonstrated that the expression of p53 and Ki-67 in the group with metastasis in axillary lymph nodes was higher than in the group without metastasis in axillary lymph nodes （χ^2 =5.257,P〈0.05; χ^2 =12.664,P〈0.05）. Conclusions To study the expressions of p53 and Ki-67 in different molecular subtypes of breast carcinoma may provide a evaluation index of the development and tumor progression of breast cancer, also contribute to the clinical treatment and prognosis of breast cancer.