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1.
We report the case of a 43-year-old woman with primary left breast cancer presenting metastatic lymphadenopathy in the contralateral axilla. This patient represents a diagnostic and therapeutic challenge because primary breast cancer, occult contralateral breast cancer, and extra-mammary primary lesion can all be the source of the contralateral axillary metastasis. Left breast-conserving surgery, left sentinel lymph node biopsy, right breast mass excision, and right axillary lymph node dissection were performed. Immunohistochemical analysis revealed that the left breast cancer specimen was positive for estrogen receptor (ER) and progesterone receptor (PR), but negative for human epidermal growth factor receptor 2 (HER2). In contrast, the right axillary lymphadenopathy specimen was negative for ER and PR, but positive for HER2. Further investigation revealed no evidence of occult primary cancers or extra-mammary tumors. After surgical intervention, the patient was treated with adjuvant chemotherapy, adjuvant radiation therapy, and targeted therapy with trastuzumab. Two years after diagnosis, she is free of disease and presently being treated with tamoxifen.Key Words: Breast carcinoma, Occult primary tumor, Contralateral axillary lymph node metastasis, Immunohistochemistry  相似文献   

2.
A 66-year-old postmenopausal woman presented in June 1991 with a giant ulcerated left breast tumor. She had discovered the tumor two years previously, but had never visited any medical institution. She was diagnosed as advanced breast cancer with multiple lung metastases, bone metastasis, and both supraclavicular lymph node metastases by physical examination, fine needle aspiration cytology, chest X-P, and bone scintigraphy. Incisional biopsy, performed to confirm the histological type of breast cancer and to evaluate estrogen and progesterone receptor (ER and PgR) status, revealed solid-tubular carcinoma. Both ER and PgR were highly positive at 322.6 and 228.0 fmol/mg protein, respectively. Therefore, endocrine therapy was chosen to treat this advanced breast cancer patient, although she had multiple organ metastases. Twenty mg of Tamoxifen a day was administered per os. After treatment with tamoxifen, the size of ulceration started to decreased and the dyspnea caused by multiple lung metastases was reduced. Eight weeks after, she showed partial response (PR) determined from the size of the ulceration and chest X-P. She has been maintaining PR for more than 9 months. Thus, Tamoxifen was shown to be very effective for this case of advanced breast cancer with multiple organ metastases.  相似文献   

3.
Assessment of the human epidermal growth factor receptor-2 (Her2/ErbB2) and estrogen receptor (ER) and progesterone receptor (PR) expression in breast cancer has been an accepted standard to predict clinical outcome. Expression of these receptors in primary breast cancer has also been an important predictor of visceral organ metastasis. Many studies of breast cancer have reported risk factors for brain metastasis that include Her2/ErbB2 positivity, ER negativity, and negativity for all the above three receptors. However, it is not clear whether expression of these receptors would persist subsequent to brain metastasis. To address this possibility, we analyzed different breast cancer brain metastases (BCBM) for the expression of Her2/ErbB2, ER, and PR by immunohistochemistry procedure. The results showed that BCBM are heterogeneous in the receptor expression: Five BCBMs were Her2/ErbB2-positive and one negative; four BCBMs were ER-positive, and two were negative; five BCBMs were PR-positive and one negative. However, expression of these receptors in their combination is also heterogeneous: Four BCBMs were positive for all of the Her2/ErbB2, ER, and PR; one BCBM was positive for Her2/ErbB2 and PR but negative for ER; one BCBM was positive for PR but negative for Her2/ErbB2/ER. Similar heterogeneity in the expression of these receptors was also observed in primary tumors. Importantly, BCBM tumors that were assigned as ER- and PR-positive contained tumor cells that lacked expression of these receptors in other regions of the biopsies. Taken together, our findings indicate that the BCBM exhibit heterogeneity in the expression amounts of Her2/ErbB2, ER, and PR, which could be a result of the influence of tumor microenvironment in the brain or different tumor cells populating the metastatic region.  相似文献   

4.
Background: Nowadays, the adjuvant treatment for breast cancer patients chosen depends on immunohistochemical pattern of Estrogen receptor(ER), Progesterone receptor(PR) and HER2 status of primary breast tumor. Several retrospective studies showed significant discordance in receptor expression between primary and metastatic tumors. The objective of this research was to determine discordant rate of ER, PR and HER2 status between primary breast cancer and synchronous axillary lymph node metastasis of individual breast cancer patients in Thammasat University Hospital. Methods: A prospective observational study of all breast cancer patients who have axillary metastasis and underwent surgery at Thammasat Hospital between January 2011 to December 2015. Tumor staging, ER, PR, and HER2 status on primary breast tumor were recorded. Synchronous axillary lymph node metastasis was evaluated with immunohistochemistry for ER, PR, and HER2. Results: The ER-positive rate from primary tumor to synchronous axillary lymph node metastasis decreased from 74.7% to 71.7%; the HER2 overexpression rate was decreased from 26% to 24%. In contrast, PR positive rate were 71% in both primary tumor and synchronous axillary lymph node metastasis. In case to case comparison, discordance rate of ER, PR and HER2 status between primary breast cancer and synchronous axillary lymph node metastasis were 11.1%, 20.2% and 10.1%, respectively. Furthermore, the tumor staging was not significant associated with discordance of ER, PR and HER2. Conclusion: ER, PR and HER 2 biomarkers showed significant concordance between primary tumor and synchronous axillary lymph node metastasis. Hence, if we cannot assess the ER, PR and HER2 status in primary tumor, then synchronous axillary lymph node metastasis can be studied instead. However, the repeat of biomarker testing in node-positive breast cancer patients may be beneficial for tailored adjuvant therapy, especially for patients with negative hormone receptor and/or HER2 profile on primary tumor.  相似文献   

5.
目的:构建乳腺癌组织芯片,研究PTEN与乳腺癌预后相关因子ER、PR、c-erbB-2、Ki67在原发性乳腺癌中的蛋白表达及其相关性。方法:制作乳腺癌组织芯片,用免疫组织化学法检测芯片上165例乳腺癌组织中PTEN、ER、PR、c-erb B-2和Ki67蛋白的表达。结果:乳腺癌组织中PTEN的高表达例数为66/163(40.5%),ER、PR、c-erb B-2和Ki67阳性率分别为51.5%、35.6%、34.4%、44.8%。PTEN阳性表达随腋淋巴结转移数、组织学分级和TNM分期的增高而降低,呈负相关性P<0.05),与肿瘤的大小和发生年龄无明显相关。乳腺癌中PTEN与ER、PR蛋白表达呈显著正相关,与c-erb B-2、Ki67蛋白表达呈负相关。结论:PTEN蛋白低表达及表达缺失与性激素失调及乳腺肿瘤细胞的生长、预后之间存在一定的联系,PTEN可作为判断乳腺癌恶性程度的潜在标志物。同时检测PTEN、ER、PR、c-erb B-2和Ki67对乳腺癌的辅助治疗具有重要意义及实用价值。  相似文献   

6.
乳腺癌彩色多普勒超声显像与ER、PR、CerbB-2的表达及意义   总被引:6,自引:0,他引:6  
[目的]探讨乳腺癌雌激素受体(ER)、孕激素受体(PR)及CerbB-2的表达与彩色多普勒血流显像(CDFI)的关系及其意义.[方法]对术前应用彩色多普勒超声检查的251例乳腺癌患者术后的肿瘤标本应用免疫组化法检测ER、PR及CerbB-2蛋白表达.[结果]在乳腺癌彩色多普勒超声显示肿块≥2cm及肿块<2cm组中的ER、PR阳性表达率差异无显著性(P>0.05);而超声显示血流分级2~3级、淋巴结转移阳性、肿瘤侵犯周边组织的病例中,其ER、PR阳性率明显低于血流分级0~1级、淋巴结转移阴性和周边组织无肿瘤侵犯病例(P<0.05);而CerbB-2阳性率则高于对应病例(P<0.05).[结论]乳腺癌彩色多普勒显像与CerbB-2、ER、PR的表达具有相关性,两者结合对于评价乳腺癌预后具有重要意义.  相似文献   

7.
目的 探讨ER、PR和HER2联合检测对乳腺癌脑转移瘤发生的预测价值.方法 选取135例乳腺癌患者作为观察对象,其中24例出现脑转移瘤患者为转移组,111例非脑转移瘤者为非转移组.采用免疫组化法(IHC),检测转移组和非转移组乳腺癌组织中ER、PR和HER2表达水平.结果 转移组ER阳性率为29.2%,显著低于非转移组的56.8%(P<0.05);转移组PR阳性率为25.0%,显著低于非转移组的54.9%(P<0.05);转移组HER2阳性率为62.5%,显著高于非转移组的18.9%(P<0.05);ER(-)、PR(-)和HER2(+)联合检测乳腺癌脑转移的灵敏度为64.00%,特异性为87.27%、准确性为82.96%.结论 乳腺癌脑转移瘤患者乳腺癌组织中ER、PR和HER2表达水平发生变化,其中ER、PR的表达缺失及HER2的过表达可能参与脑转移瘤的发生发展,ER、PR阴性表达与HER2蛋白阳性表达联合检测乳腺癌脑转移的准确性良好,可为临床应用提供参考依据.  相似文献   

8.
乳腺癌nm23基因和雌、孕激素受体表达及其临床意义   总被引:7,自引:0,他引:7  
张勇  杨学伟 《肿瘤学杂志》2004,10(6):407-409
[目的]研究nm23基因,雌激素受体(ER)、孕激素受体(PR)在乳腺癌中的表达及临床意义.[方法]应用免疫组化SP法检测60例临床及随访资料完整的乳腺癌患者标本nm23、ER、PR的表达,结合临床表现及随访结果作统计学分析.[结果]nm23、ER、PR阳性表达率分别为60.0%、73.3%、66.7%.nm23阳性表达与临床分期相关(P<0.05).nm23基因的表达与乳腺癌远处转移及腋淋巴结转移呈显著负相关(P<0.05),与生存率呈正相关(P<0.05).ER、PR阳性表达率与年龄、临床分期和淋巴结转移无关(P>0.05).ER、PR的阳性表达与乳腺癌远处转移呈显著负相关(P<0.05),与生存率呈正相关(P<0.05).在判断转移和预后方面,ER( )PR( )与nm23基因阳性表达之间存在着正相关性.[结论]检测乳腺癌组织nm23、ER、PR对评价乳腺癌患者的预后和指导临床治疗有重要价值.  相似文献   

9.
PURPOSE: The seven transmembrane receptor, GPR30, is linked to estrogen binding and heparan-bound epidermal growth factor release. Here, the significance of GPR30 in human breast cancer was evaluated by comparing its relationship to steroid hormone receptor expression and tumor progression variables. EXPERIMENTAL DESIGN: Immunohistochemical analysis of a National Cancer Institute-sponsored tumor collection comprised of 361 breast carcinomas obtained at first diagnosis (321 invasive and 40 intraductal tumors). Biopsies from 12 reduction mammoplasties served as controls. The distribution pattern of GPR30, estrogen receptor (ER), and progesterone receptor (PR) was correlated with clinicopathologic variables obtained at diagnosis. RESULTS: GPR30, ER, and PR were positive in all 12 normal controls. In contrast, GPR30 expression varied in breast tumors, in which 62% (199 of 321) of invasive tumors and 42% (17 of 40) of intraductal tumors were positive. Codistribution of ER and GPR30 was measured in 43% (139 of 321) of invasive breast tumors, whereas both receptors were lacking (ER-GPR30-) in 19% (61 of 321) of the tumors analyzed, indicating a significant association between ER and GPR30 (P<0.05). The coexpression of PR and ER did not influence GPR30 expression, yet coexpression of GPR30 and ER was linked to PR positivity. Unlike ER, which varied inversely with HER-2/neu and tumor size, GPR30 positively associated with HER-2/neu and tumor size. In addition, GPR30 showed a positive association with metastasis (P=0.014; odds ratio, 1.9). CONCLUSIONS: GPR30 and ER exhibited distinct patterns of association with breast tumor progression variables, including HER-2/neu, tumor size, and metastatic disease. Thus, these results support the hypothesis that GPR30 and ER have an independent influence on estrogen responsiveness in breast carcinoma.  相似文献   

10.
目的 Notch信号通路在乳腺癌中存在异常表达,但在不同分子分型乳腺癌中的表达情况鲜见报道.本研究将探讨不同分子分型乳腺浸润性导管癌组织中Notch1和JAG1蛋白表达及其与临床病理特征之间的关系.方法 收集滨州医学院附属医院病理科2012-01-06-2014-12-30存档的乳腺浸润性导管癌病例240例,根据ER、PR、HER2、Ki-67免疫组化结果分为管腔A型、管腔B型、HER2过表达型及三阴性型4组,每组60例,采用免疫组化En-Vision法检测不同分子分型乳腺癌中Notch1、JAG1蛋白的表达情况,对各分型乳腺癌组织的阳性表达率进行统计学分析.结果 各分型乳腺癌组织中Notch1的阳性表达差异有统计学意义(P=0.010,P<0.05),其中三阴性乳腺癌(86.67%)与管腔A型(56.67%)比较(P<0.001),HER2过表达型(83.33%)与管腔A型(56.67%)比较,差异均有统计学意义,P<0.001;Notch1的阳性表达与淋巴结转移相关(P=0.017,P<0.05),与临床分期(P=0.005,P<0.01)、组织学分级(P=0.009,P<0.01)显著相关,与ER表达(rs=-0.206,P=0.001,P<0.01)、PR表达(rs=-0.187,P=0.005,P<0.01)显著负相关,而与患者年龄、肿块大小无关.各分型乳腺癌组织中JAG1的阳性表达差异有统计学意义(P=0.035,P<0.05),以三阴性乳腺癌阳性表达率最高,但各组间两两比较差异无统计学意义;JAG1阳性表达与ER表达(rs=-0.142,P=0.015,P<0.05)、PR表达(rs=-0.127,P=0.035,P<0.05)呈负相关;Notch1和JAG1之间无明显相关性.结论 Notch1阳性表达与ER、PR表达显著负相关,与乳腺癌的组织学分级、淋巴结转移及临床分期密切相关,并在HER2过表达型,尤其是三阴性乳腺癌组织中存在高表达,有可能成为三阴性乳腺癌新的治疗靶点.  相似文献   

11.
目的:研究AT1受体、AT2受体、凋亡抑制基因p53、Survivin在乳腺癌中的表达情况,并探讨其相关性及临床意义。方法:采用免疫组化方法(SP法),对102例乳腺癌患者石蜡包埋切片中的AT1受体、AT2受体、Survivin及p53蛋白进行检测,采用χ^2检验对结果进行分析。结果:乳腺癌组织中AT1受体的阳性表达率为48%(49/102),AT1受体表达与患者年龄、肿瘤大小、ER、PR无相关性,而与腋淋巴结转移呈正相关;乳腺癌组织中AT2受体的阳性表达率为59.8%(61/102),AT2受体表达与患者年龄、肿瘤大小、ER、PR无相关性,而与腋淋巴结转移成呈负相关;AT1受体表达与p53、Survivin表达呈正相关,AT2受体表达与p53、Survivin表达呈负相关,AT1受体表达与AT2受体表达呈负相关。结论:血管紧张素Ⅱ受体参与乳腺癌肿瘤细胞凋亡。  相似文献   

12.
When distant metastases are discovered, it is important to determine receptor profiles of these lesions through histologic examination. However, brain metastasis sites are difficult to reach to be routinely biopsied. The purpose of this study was to determine expression profiles of estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2) in breast cancer brain metastasis (BCBM) and the existence of discordance between primary breast cancer and brain metastasis. A total of 37 patients who underwent craniotomies for metastatic brain tumors arising from breast cancer at National Cancer Center (NCC) of Korea between 2002 and 2014 were retrospectively reviewed. Clinicopathologic data were collected from electronic medical records. Receptor profiles of primary breast cancer and brain metastasis in each patient were identified. Data of ER, PR, and HER2 expression in brain metastasis were available in electronic medical records for 21 (56.8%) of 37 cases. Results of ER, PR, and HER2 expression were positive in 47.6, 42.9, and 38.1% of patients with brain metastasis, respectively. Receptor conversion occurred in 11 (52.4%) of 21 patients (for ER, 9.5%; for PR, 38.1%; for HER2, 23.8%). Overall survival was longer in patients with concordant receptor expression patterns between primary breast cancer and brain lesion compared to that in patients with discordant patterns. However, such difference was not statistically significant (discordant vs. concordant median survival: 19.2 versus 31.1 months, p?=?0.181). Receptor conversion in BCBMs was observed in over 50% of Korean patients used in this study. HER2 conversion was observed in 23.8% of patients in this study. Therefore, if resistance to anti-HER2 treatment is suspected in patients with BCBM, biopsy is needed to determine receptor profiles of brain lesion.  相似文献   

13.

BACKGROUND:

Changes in the receptor profile of primary breast cancers to their metastases (receptor conversion) have been described for the estrogen receptor α (ERα) and progesterone receptor (PR). The purpose of this study was to evaluate the impact of receptor conversion for ERα and PR on survival in a large group of distant non‐bone breast cancer metastases.

METHODS:

Receptor conversion was studied by immunohistochemistry in a group of 233 metastatic breast cancer patients. Kaplan‐Meier overall survival curves were plotted, and differences between the curves were analyzed by log‐rank analysis. The additional prognostic value of conversion to established prognosticators was studied by Cox regression.

RESULTS:

Overall survival of patients showing conversion from positive to negative ERα or PR, or from negative to positive ERα or PR, or remaining receptor negative was comparable, and significantly worse than patients remaining receptor positive. ERα or PR receptor conversion from positive in the primary breast tumor to negative in distant metastases has independent negative prognostic value.

CONCLUSIONS:

ERα or PR receptor conversion from positive in the primary breast cancer to negative in distant metastases has negative prognostic value. Cancer 2012. © 2012 American Cancer Society.  相似文献   

14.
背景与目的: 检测间隙连接蛋白Cx43(Connexin43,Cx43)、Cx26(Connexin26,Cx26)、血管内皮生长因子VEGF-C(Vascular endothelial growth factor-C,VEGF-C)和 雌激素受体(Estrogen receptor,ER)、 孕激素受体(Progesterone receptor,PR)在乳腺癌中的表达及其与临床病理指标的关系。材料与方法: 应用免疫组化S-P法检测乳腺癌、癌旁乳腺组织共125例石蜡包埋标本中各种蛋白的表达情况,并结合临床随访资料,用Cox比例风险模型分析其预后意义。 结果: Cx43和Cx26在癌组织中的阳性表达率分别是38.74%、43.24%,低于癌旁正常组织的阳性表达率;VEGF-C蛋白在癌组织中的阳性表达率47.75%,显著高于癌旁正常组织的阳性表达率。53例VEGF-C阳性患者中,淋巴结转移阳性者37例(69.81%),高于无转移组。多因素Cox比例风险模型分析显示,VEGF-C、Cx26和淋巴结转移与预后密切相关,危险度分别为11.118 、0.266和10.126。 结论: 间隙连接蛋白Cx43和Cx26的缺乏是人类乳腺癌的一个主要特点。随着Cx43和Cx26的阳性表达率降低,乳腺肿瘤的恶性程度增高。VEGF-C阳性表达、ER和PR阴性表达在淋巴结转移组明显高于无转移组。VEGF-C、Cx26和淋巴结转移均可能作为判断预后的独立因素。临床上联合检测这些基因产物的表达将有助于推测乳腺癌患者的预后和选择治疗方案。  相似文献   

15.
LRP16基因在乳腺癌组织中的表达及其临床意义   总被引:13,自引:0,他引:13  
Liao DX  Han WD  Zhao YL  Pu YD  Mu YM  Luo CH  Li XH 《癌症》2006,25(7):866-870
背景与目的:既往研究表明雌激素通过其受体!直接上调LRP16的表达,LRP16基因的高表达促进乳腺癌细胞的增殖。本研究旨在探讨LRP16基因在乳腺癌组织中的表达状况及其与临床病理特征的关系。方法:收集52例乳腺癌组织及其配对癌旁组织,Northernblot与半定量RT-PCR法分别检测22例和30例标本中LRP16mRNA水平。免疫组化法检测肿瘤组织中雌激素受体(ER)、孕激素受体(PR)及Ki-67的表达情况。结果:Northernblot检测结果表明,22例癌组织LRP16mRNA的表达较癌旁组织高2倍的有9例,高表达率为40.9%(9/22)。高表达LRP16的9例中有7例ER阳性,8例PR阳性;而非高表达13例中ER阳性6例,PR阳性5例,两组ER与PR阳性率均有显著性差异(P<0.05)。LRP16高表达的9例中只有1例PR和ER同时阴性,而非高表达的13例中有7例。22例患者中,13例肿瘤直径3.0~4.5cm,其中LRP16基因高表达组占8例;有腋窝淋巴结转移的12例中8例LRP16高表达。8例高表达Ki-67患者中6例LRP16高表达。半定量RT-PCR检测结果表明,30例肿瘤标本中9例(30.0%)LRP16mRNA的表达水平明显高于癌旁组织,9例LRP16高表达者ER、PR均阳性,Ki-67高表达,且瘤体直径均大于3.5cm,均有腋窝淋巴结转移,与非高表达组比较差异有显著性(P<0.05)。结论:LRP16基因表达水平与ER/PR阳性率、细胞增殖活性、肿瘤直径、远处淋巴结转移密切相关,提示LRP16基因可能参与促进乳腺癌的增殖与转移。  相似文献   

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  目的   探讨同期腋淋巴结转移病灶雌激素受体(estrogen receptor,ER)和孕激素受体(progesterone receptor,PR)补测在激素受体阴性浸润性乳腺癌中的临床意义。   方法   观察2012年7月至2013年1月,重庆医科大学附属第一医院内分泌乳腺外科门诊随访及住院患者中补测激素受体阴性乳腺癌同期腋淋巴结转移病灶ER和PR的表达情况,所有标本(包括原发癌病灶及同期腋淋巴结转移病灶)的免疫组织化学检测均由重庆医科大学病理检测中心进行,根据检测报告,原发病灶阴性而腋淋巴结转移病灶ER和/或PR阳性者补加内分泌治疗。   结果   56例激素受体阴性乳腺癌中,同期腋淋巴结转移病灶ER阳性8例(14.3%),PR阳性2例(3.6 %),ER和PR均阳性3例(5.4%),共13例(23.3%)因补查腋淋巴结转移病灶ER和/或PR变阳性而在随访中加用内分泌治疗。肿瘤原发病灶与腋转移淋巴结ER和PR均阴性43例(76.7%),即肿瘤原发癌病灶与腋转移淋巴结ER和PR均为阴性表达的总符合率为76.7%,不一致率为23.3%。   结论   受体阴性浸润性乳腺癌原发病灶与腋淋巴结转移病灶ER和PR表达具有一定的不一致性,对原发癌病灶激素受体阴性乳腺癌患者应检查其同期腋淋巴结转移病灶受体的表达,可能筛查出原发病灶受体阴性而复发转移病灶受体阳性患者,及时加用内分泌治疗,提高该类患者的疗效,亦可解释部分激素受体阴性而内分泌治疗也有一定疗效的原因。   相似文献   

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目的探讨乳腺癌的病理类型与淋巴结转移及ER、PR表达的关系。方法回顾性分析66例乳腺癌的临床病理资料。结果浸润性导管癌24例、单纯癌30例,其余12例为其他较少见的病理类型。发病平均年龄51岁,41-50岁为高峰期;单纯癌和浸润导管癌两种病理类型的淋巴结转移率和ER、PR阳性率差异无统计学差异(P〉0.05)。结论乳腺癌的发病趋向年轻化,不同病理类型与淋巴结转移率和ER、PR阳性率没有相关性。  相似文献   

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Galectin-3表达与乳腺癌进展、转移关系的研究   总被引:2,自引:0,他引:2  
目的研究galectin-3表达与乳腺癌进展及淋巴结转移的关系。方法应用组织芯片技术和免疫组织化学方法对117例浸润性乳腺癌和41例乳腺良性病变(乳腺纤维腺瘤及乳腺小叶增生)的galectin-3表达进行检测。结果Galectin-3在乳腺癌和乳腺良性病变中的阳性率分别为87.61%(99/113)和29.73%(11/37),乳腺癌组galectin-3表达率明显高于乳腺良性病变组(P〈0.001)。乳腺癌中galectin-3阳性表达与淋巴结转移(P〈0.005)、肿瘤低分化(P〈0.05)、ER阴性(P〈0.05)及c-erbB-2阳性表达(P〈0.05)有关,但与TNM分期、患者年龄及PR、E—cadherin表达的关系尚无统计学意义。结论乳腺癌中galectin-3表达可能促进肿瘤演进,并可能增加患者发生淋巴结转移的风险。  相似文献   

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