运用原位DNA末端标记法研究细胞凋亡对乳腺癌预后的影响

研究临床乳腺癌标本中细胞凋亡的发生情况,评价其在预测后在的意义。方法搜集９１例浸润性乳腺癌的石蜡组织切片,运用原位ＤＮＡ断裂位点的末端标记法,检测细胞凋亡,计算凋亡细胞占肿瘤细胞的百分比,求得凋亡指数。结果本组病例细胞凋亡发生率为９１．２％,凋亡指数分为两组：０～０．２１和０．２８～０．６２,凋亡指数高低与腋淋巴结转称相关（Ｐ＜０．０１）。生存率单因素分析中,凋亡指数高的病例,无病生存率（Ｐ＝０．００９５）及总生存率（Ｐ＝０．０３４８）均优于凋亡指数低的病例。但Ｃｏｘ模型多因素分析末能指示凋亡指数是一个独立的预后指标。结论在乳腺癌组织中,细胞凋亡是一种自发现象,其发生情况各有不同,研究初步提示了细胞凋亡在乳腺癌预后中的作用,了解了凋亡和腋淋巴结转移的相关性。

In situ DNA labeling apoptosis in breast cancer as related to prognosis

OBJECTIVE: This study was undertaken to determine the expression of apoptosis in breast cancer and to evaluate it's significance as a prognostic marker. METHODS: A series of 91 invasive breast cancer was analysed for the expression of apoptosis by using the 3-end-labeling method of DNA in tissue sections. The apoptotic indexes were the percentages of apoptotic cells among tumor cells. RESULTS: The end-labeling method allowed a precise evaluation of the expression of apoptosis. Apoptosis occurred in 91.2% of breast cancer patients, and apoptotic indexes were divided into two groups, 0-0.21 and 0.28-0.62. Low apoptotic index was related to axillary lymph node metastasis (P < 0.01). In survival analysis, higher apoptotic index was related to disease free survival (P = 0.0095) and overall survival (P = 0.0348) in the entire cohort. Cox's analysis showed apoptotic index had no independent prognostic value. CONCLUSION: The apoptosis was a spontaneous phenomenon in breast cancer tissue, and the expression was different from each other. Further analysis was needed to clarify the relationship between apoptosis and prognosis, especially the response to adjuvent therapy.