乳腺癌组织中雌激素受体和孕激素受体及细胞周期蛋白D1的表达及其临床病理意义

目的　探讨生物标志物雌激素受体(ER)、孕激素受体(PR)及细胞周期蛋白(CyclinD1)在乳腺浸润性导管癌组织中的表达与肿瘤生物学的特点及与预后的关系,为患者术后化疗方案选择的提示作用。方法　用免疫组化SP法检测100例乳腺浸润性导管癌中ER、PR、CyclinD1蛋白的表达并随访分析患者的术后治疗情况和生存状态。结果　ER阳性率为60%,PR阳性率58%, CyclinD1阳性率55%。CyclinD1阴性者总体生存时间要短于阳性者(P=0. 0053)。CyclinD1和ER均为阳性者预后好于均为阴性者(Pdfs<0 .01, Pos<0. 01)。ER阳性者化疗后平均无瘤生存时间(55 .4个月)长于ER阴性者(35 .8个月),PR阳性表达者化疗后平均无瘤生存时间(55.4个月)长于PR阴性者(37. 8个月)。CyclinD1阴性,单独使用环磷酰胺、阿霉素、5 氟脲嘧啶(CAF)治疗的患者平均无瘤生存时间和总体生存时间均长于使用其他方案者。结论　ER、PR阳性患者的无瘤生存时间长,化疗后无瘤生存时间较长。CyclinD1阳性患者的总体生存时间长。CyclinD1为阴性,单独使用CAF组患者比使用其他化疗方案组预后更好。

Expression of ER, PR and cyclin D1 in breast infiltrating ductal carcinoma and their clinicopathological significance

OBJECTIVE: To investigate the expression of cyclin D1, ER, and PR gene proteins and to analyze their relevance to tumor biological characteristics, chemotherapy effects, diseases free survival (DFS) and overall survival (OS) of patients. METHODS: Immunohistochemical staining techniques was used to detect the expression of cyclin D1, ER and PR gene protein in 100 samples of breast infiltrating ductal carcinoma patients, all female, aged 49.49 +/- 10.81 (28 approximately 92). RESULTS: The positive expression rate of gene protein was 60& for ER 58% for PR, and 55% for cyclin D1 ER, PR presented a negative correlation to SBR grading. Patients with cyclin D1 positive tumor had longer OS than those with cyclin D1 negative tumor (P = 0.0053). Coexpression of cyclin D1 and ER was significantly correlated with longer DFS and OS (P(dfs) = 0.0108, P(os) = 0.0030). The positivity of ER and PR was significantly correlated with longer DFS (P(ER) = 0.0322, P(PR) = 0.0129). For those patients receiving postoperative adjuvant chemotherapy, the expression of ER and PR were correlated with a better prognosis and longer DFS. The patients with cyclin D1 negative tumor, who received CAF, had a mean DFS of 51.6 months and a mean OS of 57 months in comparison with 24.8 months and 31.2 months for those patients who received other chemotherapy. CONCLUSION: In breast infiltrating ductal carcinoma patients expression of ER and of PR are correlated with longer DFS, cyclin D1 expression is correlated with longer OS. For the patients receiving postoperative adjuvant chemotherapy, the expression of ER and PR correlated to a better prognosis and longer DFS. The patients with cyclin D1 negative tumor who receive CAF chemotherapy have longer DFS and OS than those receiving other chemotherapy.