ER-α30和ER-α36在乳腺癌组织的表达及意义

目的探讨新型雌激素受体亚型ER-α30和ER-α36在乳腺癌中的表达及与他莫昔芬治疗预后的关系。方法收集2015年1月至2015年11月间在河北北方学院附属第一医院接受他莫昔芬内分泌治疗的Luminal A型乳腺癌患者75例,并收集同时期30例ER(-)乳腺癌患者组织。采用免疫组化染色SP法检测ER-α30和ER-α36蛋白表达。分析ER-α30和ER-α36蛋白表达与Luminal A型乳腺癌临床病理特征的关系。随访患者的无病生存时间(DFS)。采用Cox风险比例回归模型分析影响DFS的因素。结果Luminal A型乳腺癌组织中ER-α30蛋白阳性表达率为32.0%(24/75),低于ER(-)乳腺癌组织(P<0.05)。ER-α30蛋白表达与TNM分期、肿瘤直径、浸润深度、淋巴结转移、孕激素受体状态有关(P<0.05)。ER-α36蛋白阳性表达率为52.0%(39/75),与ER(-)乳腺癌组织比较差异无统计学意义(P>0.05)。ER-α36蛋白表达与TNM分期和肿瘤直径有关(P<0.05)。随访时间为11~54个月,患者48个月无病生存率为64.0%(48/75)。ER-α30阳性患者48个月无病生存率为33.33%(8/24),阴性患者为78.43%(40/51),差异具有统计学意义(P=0.001)。ER-α36阳性患者48个月无病生存率为48.7%(19/39),阴性患者为80.6%(29/36),差异具有统计学意义(P=0.002)。Cox风险比例回归分析显示,ER-α30、ER-α36是影响Luminal A型乳腺癌患者DFS的独立预后因素(P<0.05)。结论Luminal A型乳腺癌ER-α30和ER-α36阳性表达者接受他莫昔芬治疗无病生存期较短,其有望成为预测他莫昔芬治疗反应性的重要指标。

Expression and significance of ER-α30 and ER-α36 in Luminal A breast cancer

Objective To investigate the expression of estrogen receptorα30(ER-α30)and ER-α36 in breast cancer and their relationship with the prognosis of tamoxifen.Methods From January 2015 to November 2015,75 cases of Luminal A breast cancer patients who received tamoxifen endocrine therapy in the First Affiliated Hospital of Hebei North University were collected,and 30 cases of ER(-)breast cancer patients in the same period were collected.The expression of ER-α30 and ER-α36 was detected by SP immunohistochemistry.The relationship between the expression of ER-α30 and ER-α36 and the clinicopathological features of Luminal A breast cancer was analyzed.The disease-free survival time(DFS)was followed up.Cox risk ratio regression model was used to analyze the factors influencing DFS.Results The positive expression rate of ER-α30 protein in Luminal A breast cancer tissues was 32.0%(24/75),lower than that in ER(-)breast cancer tissues(P<0.05).ER-α30 protein expression was associated with TNM stage,tumor diameter,invasion depth,lymph node metastasis,and progesterone receptor status(P<0.05).The positive expression rate of ER-α36 was 52.0%(39/75),with no significant difference from ER(-)breast cancer(P>0.05).ER-α36 protein expression was associated with TNM stage and tumor diameter(P<0.05).Patients were followed up for 11 to 54 months,and the 48-month disease-free survival rate was 64.0%(48/75).The 48-month disease-free survival rate was 33.33%(8/24)for the ER-α30 positive patients and 78.43%(40/51)for the negative patients,with statistically significant differences(P=0.001).The 48-month disease-free survival rate was 48.7%(19/39)for the ER-α36 positive patients and 80.6%(29/36)for the negative patients,with statistically significant differences(P=0.002).Cox risk ratio regression analysis showed that ER-α30 and ER-α36 were independent prognostic factors for DFS in Luminal A breast cancer patients(P<0.05).Conclusion Luminal A breast cancer patients with positive expression of ER-α30 and ER-α36 had A shorter disease-free survival after receiving tamoxifen,which is expected to be an important indicator of the reactivity of tamoxifen treatment.