Vimentin和E-cadherin蛋白在乳腺癌组织中的表达及其临床意义

目的: 研究波形蛋白（Vimentin）和E-钙黏蛋白（E-cadherin）在人乳腺癌组织中的表达及其临床意义。方法: 回顾性分析2014 年1 月至2016 年1 月在安徽医科大学附属巢湖医院接受乳腺癌根治术的56 例乳腺癌组织和相应癌旁组织标本以及病历资料，用免疫组织化学染色法和qPCR 分别检测癌组织中Vimentin、E-cadherin 蛋白和mRNA的表达，分析Vimentin 和E-cadherin蛋白在乳腺癌组织中的表达与临床病理特征的关系。用Logistic 多因素回归分析影响Vimentin 和E-cadherin 蛋白表达的独立因素，用Spearman 分析Vimentin 与E-cadherin 蛋白表达的相关性，用Kaplan-Meier 分析Vimentin 和E-cadherin 蛋白表达与预后的关系，用ROC曲线分析Vimentin 和E-cadherin 蛋白表达对预后的诊断。结果: 56 例乳腺癌组织中Vimentin 和E-cadherin 蛋白高表达率分别为76.79%和19.64%；其中47 例（47/56,83.93%）乳腺癌组织中Vimentin mRNA 的表达量显著高于癌旁组织（P<0.05），46 例（46/56，82.14%）乳腺癌组织中E-cadherin mRNA的表达量显著低于癌旁组织（P<0.05）。Vimentin 蛋白表达与肿瘤大小、淋巴结转移、脉管侵袭、组织学分级、临床分期、分子分型、Ki67 阳性、ER阴性、PR阴性及HER2 阴性表达均有关（均P<0.05）；E-cadherin 蛋白表达与淋巴结转移、脉管侵袭、组织学分级、临床分期、分子分型、Ki67 阳性、ER阴性、PR阴性及HER2 阴性表达均有关（均P<0.05）。肿瘤大小、淋巴结转移、脉管侵袭、组织学分级、临床分期、分子分型、Ki67 阳性、ER阴性、PR阴性及HER2 阴性表达均是促进Vimentin 和E-cadherin 表达的独立影响因素（P<0.05），且Vimentin 与E-cadherin 蛋白表达呈负相关关系（P<0.05）。Vimentin 蛋白高表达的患者3 年生存率为67.44%，E-cadherin 蛋白低表达的患者3 年生存率为68.89%。结论: 在乳腺癌组织中Vimentin高表达和E-cadherin低表达与乳腺癌发生发展、侵袭转移及患者预后有关，可作为临床诊断与预后的评价指标。

Expression and clinical significance of Vimentin and E-cadherin in breast cancer tissues

Objective: To study the expression and clinical significance of Vimentin and E-cadherin in human breast cancer tissues.Methods: The clinical data of 56 cases of breast cancer patients, who underwent radical mastectomy in Chaohu Hospital Affiliated to Anhui Medical University from January 2014 to January 2016, were retrospectively analyzed. The protein and mRNA expressions of Vimentin and E-cadherin in breast cancer tissues were detected by immunohistochemistry and qPCR, respectively; and the relationship between the expression of Vimentin and E-cadherin in breast cancer tissues and the clinicopathological characteristics was analyzed. Logistic multivariate regression was used to analyze the independent factors affecting the protein expressions of Vimentin and E-cadherin.Spearman was used to analyze the correlation between Vimentin and E-cadherin. Kaplan-Meier was used to analyze the relationship between protein expressions of Vimentin, E-cadherin and prognosis. ROC curve was used to analyze the diagnostic value of Vimentin and E-cadherin on prognosis. Results: The rates of breast cancer tissues with high positive expression of Vimentin and E-cadherin were 76.79% and 19.64%, respectively. Among them, 47 cases (47/56, 83.93%) of breast cancer tissues showed significantly higher Vimentin mRNA expression than adjacent tissues (P<0.05), and 46 cases (46/56, 82.14%) of breast cancer tissues showed significantly lower Ecadherin mRNA expression than adjacent tissues (P<0.05). Vimentin protein expression was associated with tumor size, lymph node metastasis, vascular invasion, histological grade, clinical stage, molecular typing, Ki67+, ER-, PR- and HER2- expression (P<0.05). And E-cadherin protein expression was associated with lymph node metastasis, vascular invasion, histological grade, clinical stage, molecular typing, Ki67+, ER-, PR- and HER2- expression (P<0.05). Tumor size, lymph node metastasis, vascular invasion, histological grading,clinical staging, molecular typing, Ki67+ , ER- , PR- and HER2- expression were all independent factors affecting the expression of Vimentin and E-cadherin (P<0.05). There was a negative correlation between Vimentin and E-cadherin expression (P<0.05). The 3-year survival rate of patients with high expression of Vimentin protein was 67.44%, while that of patients with low expression of E-cadherin protein was 68.89%. Conclusion: The high expression of Vimentin and low expression of E-cadherin in breast cancer tissues may be related to the occurrence, development, invasion and metastasis of breast cancer. It can be used as a reliable indicator of clinical diagnosis and prognosis.