乳腺癌组织中乳腺癌易感基因1、增殖细胞核抗原Ki-67表达的临床意义

目的 探讨乳腺癌组织中乳腺癌易感基因1（BRCA1）、增殖细胞核抗原Ki-67表达的临床意义.方法 采用免疫组织化学法检测194例乳腺癌病理组织标本BRCA1、Ki-67的表达情况,并对其与临床病理参数的相关性进行分析.结果 194例乳腺癌中,淋巴结阳性组、雌激素受体（ER）/孕激素受体（PR）阴性组和人表皮生长因子受体2（HER-2）阳性组的BRCA1低表达率较高（P＜0.05）,三阴组中BRCA1低表达率高于非三阴组（P＜0.05）;Ki-67高表达者多为组织分级较高、ER/PR阴性和HER-2阳性患者（P＜0.05）;且BRCA1和Ki-67具有负相关性（P＜0.05）,绝经后、组织分级低、淋巴结阳性、ER/PR阴性、HER-2阳性患者的BRCA1低表达合并Ki-67高表达所占比例较高（P＜0.05）,但在三阴组与非三阴组间差异无统计学意义.结论 联合检测BRCA1、Ki-67对乳腺癌的临床转归具有一定预测意义,尤其是BRCA1可作为三阴性乳腺癌的预后因素之一.     

乳腺癌患者人表皮生长因子受体2基因扩增状态与临床病理特征的关系

目的探讨乳腺癌患者人表皮生长因子受体2(HER2)基因的扩增状态与患者临床病理特征相关性,并分析乳腺癌患者腋窝淋巴结转移的影响因素。方法收集2016年1月至2019年3月在滕州市中心人民医院病理科做常规病理检查且HER2免疫组织化学(IHC)结果为++的262例乳腺癌患者病理资料,包括年龄、肿瘤长径、组织学分级、病理类型、是否有淋巴结转移、肿瘤数量、肿瘤部位;用IHC法检测石蜡标本p53、Ki-67、雌激素受体(ER)、孕激素受体(PR)的表达结果;用荧光原位杂交(FISH)法检测HER2基因的扩增状态;分析HER2基因扩增是否与上述临床病理特征相关,以及腋窝淋巴结转移是否与上述特征相关。结果262例乳腺癌患者有69例HER2扩增阳性,阳性扩增率为26.3%;HER2基因扩增与Ki-67增殖指数和ER、PR的表达状态相关,差异有统计学意义(χ^2=13.27,P<0.01;χ^2=34.97,P<0.01;χ^2=38.31,P<0.01);与年龄、肿瘤长径等其余临床病理特征均无关(均P>0.05)。262例乳腺癌患者中发生腋窝淋巴结转移106例(40.5%);淋巴结转移与肿瘤长径显著相关(χ^2=29.10,P<0.01),与其余临床病理特征均无相关(均P>0.05)。结论乳腺癌HER2基因扩增状态与Ki-67增殖指数和ER、PR的表达相关,肿瘤大小为影响乳腺癌患者腋窝淋巴结转移的因素,准确判断上述指标能更好地指导乳腺癌患者的治疗和评估预后。     

Alterations of biomarker profiles after neoadjuvant chemotherapy in breast cancer: tumor heterogeneity should be taken into consideration

Tumor biomarkers including estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2 (HER2) and Ki-67 are routinely tested in breast cancer patients and their status guides clinical management and predicts prognosis. A few retrospective studies have suggested that neoadjuvant chemotherapy (NAC) in breast cancer may change the status of biomarker expression, which in turn will affect further management of these patients. In this study we take advantage of a relatively large cohort and aim to study the effect of NAC on biomarker expression and explore the impact of tumor size and lymph node involvement on biomarker status changes. We collected 107 patients with invasive breast cancer who received at least three cycles of NAC. We retrospectively performed and scored the immunohistochemistry (IHC) of ER, PR, HER2 and Ki-67 using both the diagnostic core biopsies before NAC and excisional specimens following NAC. HER2 gene status was assessed by fluorescence in situ hybridization for cases with IHC result of 2+. We demonstrated that there was a significant decrease in expression of PR (P = 0.013) and Ki-67 (P = 0.000) in post-NAC specimens compared to pre-NAC core biopsies. In addition, cases with large tumor size (≥2cm) and cases with lymph node metastasis were more frequently to have biomarker changes. Finally we studied cases with HER2 status changes after NAC treatments in detail and emphasized the nature of tumor heterogeneity.     

Correlations between HER2 Expression and Other Prognostic Factors in Breast Cancer: Inverse Relations with the Ki-67 Index and P53 Status

Background: Overexpression or amplification of human epidermal growth factor receptor-2 (HER2) is associated with grade of malignancy and a poor prognosis in breast cancer (BC). The aim of this study was to evaluate of value of HER2 as a prognostic marker, and to analyze associations with common histopathological parameters in BC cases. Materials and Methods: Between of 2007 to 2014, 260 patients with BC referred to Oncology Clinic provided cancer tissue samples which underwent immunohistochemistry (IHC) for markers. ER and PR positivity was defined as 10% positive tumor cells with nuclear staining. HER2-positive was defined as either HER2 gene amplification by fluorescent in situ hybridization (FISH) or scored as 3 by IHC. For HER2 (2), FISH was performed to determine HER2 positivity. Results: The mean age at diagnosis for the patients with HER2-negative was significantly higher than in HER2-positive cases. Also, there were significant correlations between histological grade, nuclear grade, lymph node metastasis, tumor size, ER status, PR status, p53 overexpression and Ki-67 index with HER2 expression. HER2-negative lesions were of higher grade and more likely to be ER-negative, PR-negative, p53-positive, lymph node metastasis, with a tumor sizealso Ki-6720% as compared to the HER2-positive group. Conclusions: Contrary to the results of other studies, HER2-positive tumors in our study had a lower Ki-67 index and were p53-positive. Also, Ki-67 proliferation index 20% in more studies was associated with p53-positive.Therefore, tumors which are HER2-positive and have a Ki-6720% had a more aggressive behavior compared to HER2-positive and Ki-67<20% lesions.     

Luminal B 型早期乳腺癌临床病理特点及预后危险因素分析

目的:探讨Luminal B型早期乳腺癌临床病理特点及影响预后的因素。方法:回顾性分析2010年01月至2016年06月我院收治的Luminal B型乳腺癌患者285例,分析其临床病理特点和影响预后的相关因素。结果:Luminal B(HER-2阴性)乳腺癌患者190例（66.7%）,Luminal B(HER-2阳性)患者为95例（33.3%）。Luminal B(HER-2阴性)与Luminal B(HER-2阳性)在脉管癌栓、腋窝淋巴结状态和放疗例数差异具有统计学意义（P＜0.05）。Luminal B(HER-2阳性)复发转移率高（P＜0.05）,且5年的无病生存和总生存率均低于Luminal B(HER-2阴性) （P＜0.05）。单因素和多因素分析显示脉管癌栓、淋巴结状态、PR和Ki-67是Luminal B型乳腺癌预后独立的影响因素（P＜0.05）。结论:与Luminal B(HER-2阴性)相比,Luminal B(HER-2阳性)乳腺癌患者恶性程度更高,预后更差。脉管癌栓、淋巴结转移、Ki-67高表达和PR阴性是影响Luminal B型乳腺癌预后的独立危险因素。     

影响青年乳腺癌患者新辅助化疗后病理完全缓解和预后的病理因素分析

目的:探讨影响青年乳腺癌患者新辅助化疗（neoadjuvant chemotherapy,NAC）后病理完全缓解（pathological complete response,pCR）和预后的临床病理因素。方法:回顾性分析2010年01月至2018年12月我院甲乳外科收治年龄≤35岁行NAC的女性乳腺癌患者的临床病理资料。NAC后依据Miller-Payne评分系统,将患者分为pCR组和非pCR组。探讨临床病理因素对青年乳腺癌患者pCR、复发转移和死亡的影响,同时分析pCR与无病生存期（disease free survival,DFS）与总生存期（overall survival,OS）之间的相关性。结果:168例患者中pCR 37例,pCR率为22.0%。体质量指数(body mass index,BMI)、术前淋巴结状态、雌激素受体（estrogen receptor,ER）、孕激素受体（progesterone receptor,PR）、人类表皮生长因子受体2（human epidermal growth factor receptor-2,HER-2）、Ki-67、p53及分子分型与青年乳腺癌患者NAC后的pCR率关系密切（P＜0.05）。肿瘤大小、术前淋巴结状态、ER、PR、HER-2、p53及分子分型影响患者的复发转移和死亡（P＜0.05）,同时肿瘤大小、术前淋巴结状态、组织学分级、ER、PR、HER-2、Ki-67及分子分型均是DFS和OS的独立影响因素（P＜0.05）。66例复发转移患者中pCR患者7例,占pCR患者的18.9%（7/37）,pCR组和非pCR组DFS比较差异具有统计学意义（P＜0.05）。38例死亡患者中pCR患者3例,占pCR患者的8.1%（3/37）,pCR组和非pCR组OS比较差异具有统计学意义（P＜0.05）。结论:影响青年乳腺癌患者pCR和预后的临床病理因素较多,获得pCR的患者具有更好的远期预后。     

新辅助化疗对乳腺癌疗效和雌激素受体孕激素受体Ki-67和人表皮生长因子受体2表达的影响分析

目的了解新辅助化疗（NAC）在局部进展期乳腺癌治疗前后ER、PR、Ki-67及HER-2的变化,探讨其与新辅助化疗疗效之间的相关关系。方法 46例接受新辅助化疗的乳腺癌患者纳入研究,分析患者术前弹射式空芯针穿刺活检标本和术后大标本癌组织ER、PR、Ki-67和HER-2表达的变化。患者化疗前行乳腺肿瘤粗针穿刺活检并免疫组化方法检测肿瘤组织ER、PR、Ki-67和HER-2的表达。化疗后评估疗效并对接受手术的患者的手术标本通过同法检测各指标的表达。结果新辅助化疗前后ER、PR、Ki-67和HER-2的表达均发生了改变,新辅助化疗前ER、PR、Ki-67和HER-2阳性表达的肿瘤组织新辅助化疗后下调（ER：82.6%和80.4%;PR：78.3%和71.7%;Ki-67：39.1%和30.4%;HER-2：28.3%和26.1%）,但没有统计学意义（P〉0.05）。ER、PR、Ki-67和HER-2阳性表达疗效有效率与阴性表达有效率分别为ER：68.4%和50.0%;PR：66.7%和60.0%;Ki-67：77.8%和57.1%;HER-2：53.8%和69.7%。ER、PR、Ki-67、HER-2表达状态与化疗效果均无明显的关系（均P〉0.05）。结论新辅助化疗可以改变ER、PR、Ki-67和HER-2的表达,本临床研究未发现ER、PR、Ki-67和HER-2的变化与局部进展期乳腺癌的新辅助化疗疗效有相关关系。     

Tissue microarray analysis of connexin expression and its prognostic significance in human breast cancer

Breast cancer accounts for approximately 15% of all cancer deaths. Currently, axillary nodal status is the most reliable prognostic indicator for breast cancer. Tumor size and histological grade are used to stage breast cancer. Estrogen receptor/progesterone receptor (ER/PR) and HER-2/neu status are useful in predicting patient survival and relapse. Ki67, an indicator of proliferative activity, also correlates well with prognosis. Connexin proteins form gap junction channels, permitting intercellular exchange of ions and small molecules. Reduced connexin protein levels and impaired gap junctional intercellular communication are associated with tumor phenotypes. This study investigated the prognostic value of connexin proteins as breast cancer markers. Tissue microarrays, containing 438 cases of invasive breast carcinoma, were stained with Cx26, Cx32, and Cx43 antibodies. The degree of connexin immunoreactivity was determined and then correlated with patient outcome, tumor grade, tumor size, lymph node status, and immunohistochemical markers, such as p53, ER/PR status, Ki67 and c-erbB-2 expression. Cx26, Cx32, or Cx43 did not correlate well with tumor grade, tumor size, p53 or c-erbB-2 status. There was an inverse correlation between Cx32 and lymph node status (P <0.05) and a positive correlation between Cx43 and PR status (P <0.01). Cx32 and Cx43 correlated positively with ER status (P <0.01). Cx43 correlated negatively with Ki67 expression (P <0.01). Cx26, Cx32, and Cx43 did not correlate with patient outcome. Based on our observations in this study, connexin proteins do not appear to be reliable indicators of breast cancer prognosis.     

Prognostic relevance of Ki-67 in the primary tumor for survival after a diagnosis of distant metastasis

Prediction of the prognosis for metastatic breast cancer patients depends on molecular subtypes similar to those found in patients with primary breast cancer. Several studies have shown that estrogen receptor (ER) and progesterone receptor (PR) status determine the course of the disease and the prognosis. As Ki-67 helps to differentiate molecular subtypes in patients with primary breast cancer, the aim of this study was to assess the prognostic relevance of Ki-67 in the primary tumor in relation to its prognostic relevance for patients with metastatic breast cancer. A total of 467 patients with invasive breast cancer were identified in the database of a single breast cancer center, in whom Ki-67 had been assessed in tumor material from the breast at the time of the primary diagnosis and who had developed a metastasis at any time during the subsequent course. For these patients, tumor and patient characteristics were used to determine prognostic factors relative to overall survival after the diagnosis of distant metastases. Ki-67 was added to this model to investigate whether this might improve the prediction of overall survival. In the multivariate Cox model, age at diagnosis, body mass index, nodal status, tumor size, ER and PR status, and time from diagnosis to metastasis were identified as relevant prognostic factors. Adding Ki-67 to the model improved the prediction of overall survival. There was also a significant and relevant interaction with the PR status. In patients with a low-proliferation primary tumor, a high level of PR expression would indicate an extraordinarily good prognosis (HR 0.39; 95 % CI, 0.23–0.66). In patients with higher-proliferation primary tumors, PR status was not capable of differentiating prognostic groups. Ki-67 is useful in addition to known prognostic factors for breast cancer. It is able to indicate a group of women with a poorer prognosis, specifically in the group of patients with PR-positive breast cancer.     

乳腺癌组织中ERβ及其异构体ERβ1、ERβcx的表达及其临床意义

目的 探讨雌激素受体β（ERβ）及其异构体（ERβ1、ERβcs）在人类表皮生长因子受体2（HER-2）阳性与阴性乳腺癌组织中的表达差异,分析其与雌激素受体α（ERα）、孕激素受体（PR）表达及临床分期和腋窝淋巴结状况的关系。方法采用简单随机抽样的方法选择中山大学附属第一医院2004年12月至2007年12月收治的HER-2高表达（卅）51例与无表达（一）53例乳腺浸润性导管癌病例,分别检测乳腺癌组织的ERα、ERβ、ERβ1、ERβcx及PR表达水平,分析其相互关系及与肿瘤临床分期、腋窝淋巴结转移等临床指标的相关性。采用x^2检验对HER-2（卅）组与（一）组淋巴结表达情况进行对比分析,对HER-2（卅）及HER-2（一）组内各指标采用Spearman相关性分析。结果 在HER-2（卅）与（一）两组中临床分期及淋巴结转移率差异均无统计学意义（P〉0．050）;HER-2（卅）组ERα、ERβ1、ERβcx、PR的阳性表达率均低于HER-2（一）组,差异均有统计学意义（P〈0．050）。HER-2（卅）组中,ERβ1与ERα的表达、ERβcx与PR的表达均呈正相关（P〈0．050）,但ERG、ERβ1及ERβx均未显示与淋巴结转移状况及临床分期相关（P〉0．050）。HER-2（一）组中,HEβ1及ERβcx的表达均与ERα、ERβ1、ERβ、PR呈正相关（P〈0．050）,但ERα、ERβ、ERβ1及ERβcx均与淋巴结转移情况及临床分期无显著相关性（P〉0．050）。结论 ERβ1和ERβcx可能作为乳腺癌预后良好的指标,有必要进一步研究其与乳腺癌治疗后的生存关系。     

乳腺癌组织中ER、PR、cerbB-2、Ki-67表达及其意义

目的探讨乳腺癌组织中雌激素受体（ER）、孕激素受体（PR）、cerbB-2和Ki-67基因的表达及其临床意义。方法采用S-P免疫组化方法,检测107例乳腺癌组织中ER、PR、cerbB-2、Ki-67的表达水平,并结合其患者的相关临床资料进行分析。结果乳腺癌组织中ER、PR、cerbB-2、Ki-67阳性表达率分别为56.1%、82.2%、71.0%、67.3%。ER、PR、cerbB-2、Ki-67阳性表达与乳腺癌腋窝淋巴结转移和临床分期显著相关（P〈0.05）。而与患者年龄、肿瘤大小无相关性（P〉0.05）。相关分析结果显示ER与PR表达呈正相关（P=0.000）,与Ki-67表达呈负相关（P=0.000）;PR与cerbB-2、Ki-67表达呈负相关（P=0.012、0.006）。结论 ER、PR和cerbB-2、Ki-67与乳腺癌的发生、发展有关,联合检测ER、PR、cerbB-2和Ki-67,有助于客观评估乳腺癌的生物学行为,从而指导临床治疗和预后判断。     

乳腺癌DCE-MRI表现特征与生物因子表达及淋巴结转移的相关性研究

目的探索乳腺癌动态增强磁共振成像(DCE MRI)表现特征与生物因子雌激素受体(ER)、孕激素受体(PR)、人类表皮生长因子受体 2(Her 2)、Ki 67表达状态及淋巴结转移的关系。方法选取2015年6月至2019年5月连云港市第一人民医院收治的经病理确诊为乳腺癌的80例患者(80个病灶),分析患者的DCE MRI特征:肿瘤直径、肿瘤形态、肿瘤边缘、强化方式、时间 信号强度曲线(TIC)及早期强化率(ΔSI)。采用免疫组织化学染色分析ER、PR、Her 2、Ki 67的表达情况。分析乳腺癌患者的DCE MRI表现特征与ER、PR、Her 2、Ki 67阳性表达状态及淋巴结转移之间的关系。结果直径≤2 cm、2 cm<直径≤5 cm及直径>5 cm肿瘤的PR阳性表达率组间差异具有统计学意义（P=0024）;形态为类圆形、分叶状及不规则形肿瘤的PR阳性表达率组间差异有统计学意义（P=0040）;直径>5 cm肿瘤发生淋巴结转移的概率较直径≤2 cm肿瘤及2 cm<直径≤5 cm肿瘤高（均P<005）。肿瘤边缘与Her 2表达水平呈正相关(r=0276,P=0013),早期强化率与Ki 67表达水平呈正相关(r=0254,P=0023)。结论乳腺癌DCE MRI表现特征在一定程度上可以初步评估乳腺癌细胞的生物学行为,为指导临床综合治疗及评估患者预后提供客观依据。     

C-erbB-2、p53、Ki-67及VEGF在乳腺癌中的表达及相关性

目的探讨C-erbB-2、p53、Ki-67及VEGF在乳腺癌组织中的表达及其与乳腺癌临床病理特征之间的相关性。方法采用免疫组化SP法检测72例乳腺癌组织中C-erbB-2、p53、Ki-67及VEGF表达情况,并结合临床病理特征进行相关性分析。结果乳腺癌患者C-erbB-2、p53、Ki-67及VEGF阳性表达率分别为47.2%、48.6%、56.9%、65.3%。C-erbB-2、p53表达与淋巴结转移、雌激素受体、孕激素受体相关(P<0.05);Ki-67、VEGF与肿瘤直径、淋巴结转移相关(P<0.05);ER和PR呈正相关(P<0.05);C-erbB2与ER、PR呈负相关(P<0.05);p53与ER和PR呈负相关(P<0.05);p53、Ki-67、VEGF之间均呈正相关(P<0.05)。结论 C-erbB-2、p53、Ki-67及VEGF检测对判断乳腺癌预后有重要意义。     

Roles of Ki67 in Breast Cancer - Important for Management?

Background: The three standard biomarkers used in breast cancer are the estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor 2 (HER2). The Ki-67 index, a proliferative marker, has been shown to be associated with a poorer outcome, and despite absence of standardization of pathological assessment, is widely used for therapy decision making. We aim to study the role of the Ki-67 index in a group of Asian women with breast cancer. Materials and Methods: A total of 450 women newly diagnosed with Stage 1 to 3 invasive breast cancer in a single centre from July 2013 to Dec 2014 were included in this study. Univariable and multivariable logistic regression was used to determine the association between Ki-67 (positive defined as 14% and above) and age, ethnicity, grade, mitotic index, ER, PR, HER2, lymph node status and size. All analyses were performed using SPSS Version 22. Results: In univariable analysis, Ki -67 index was associated with younger age, higher grade, ER and PR negativity, HER2 positivity, high mitotic index and positive lymph nodes. However on multivariable analysis only tumour size, grade, PR and HER2 remained significant. Out of 102 stage 1 patients who had ER positive/PR positive/HER2 negative tumours and non-grade 3, only 5 (4.9%) had a positive Ki-67 index and may have been offered chemotherapy. However, it is interesting to note that none of these patients received chemotherapy. Conclusions: Information on Ki67 would have potentially changed management in an insignificant proportion of patients with stage 1 breast cancer.     

E-cadherin在乳腺浸润性导管癌中的表达及临床意义

目的 探讨E-钙黏蛋白（E-cad）在乳腺浸润性导管癌中的表达及其与乳腺癌临床病理特征、淋巴结转移及预后的关系。方法 采用免疫组织化学 SP 法检测30例乳腺纤维腺瘤、450例乳腺浸润性导管癌组织中E-cad的表达,分析其表达与临床病理特征的关系, Kaplan-Meier法绘制生存曲线。结果E-cad在无淋巴结转移乳腺癌组织中阳性表达率为49.04％（77／157）,在有淋巴结转移的乳腺癌组织中阳性表达率为29.69％（87／293）,差异有统计学意义（P＜0.05）。E-cad表达与年龄、淋巴结转移、肿块大小、ER表达、分子分型及组织学分级有关（P＜0.05）,而与肿瘤分期、是否绝经、HER-2及Ki-67表达情况无关。乳腺癌淋巴结转移组、三阴性乳腺癌组中E-cad阳性表达者5年生存率优于E-cad阴性表达者,差异有统计学意义（P＜0.05）。结论 E-cad表达与乳腺癌淋巴结转移关系密切,其亦可成为乳腺癌伴淋巴结转移者或三阴性乳腺癌预后的判断指标。     

ER，PR，Her-2及Ki-67在乳腺癌原发灶和前哨淋巴结转移灶中的表达对比研究

目的:探讨ER、PR、Her-2及Ki-67在乳腺癌原发灶和前哨淋巴结转移灶中的表达变化及其临床病理意义。方法:收集50例具有乳腺癌原发灶和前哨淋巴结转移灶的病例,采用免疫组化及原位杂交分析原发灶和前哨淋巴结转移灶中ER、PR、Her-2及Ki-67的表达有无差异。结果:ER在乳腺癌原发灶和SLN转移灶中表达一致率为100%。PR原发灶和转移灶一致率为92%,变化率为8%,Her-2原发灶和转移灶一致率为96%,变化率为4%,表达变化均无统计学意义（P＞0.05）。Ki-67在乳腺癌原发灶表达率为（30.3±20.2）%,SLN转移灶表达率（25.1±17.6）%,差异具有统计学意义（P＜0.05）;Ki-67原发灶和转移灶表达一致率为70%,变化率为30%,但表达变化无统计学意义（P＞0.05）。补充腋窝淋巴结阳性率在原发灶高表达、SLN转移灶中变为低表达组22.2%（2/9）明显低于无变化组62.5%（15/24）,差异具有统计学意义（P=0.04）。结论:原发灶基本能反应SLN转移灶ER、PR、Her-2表达状态,但针对个体而言,SLN转移灶分子状态重新评价仍有益。Ki-67在SLN转移灶表达率降低,原发灶高表达而SLN转移灶变为低表达可能预测补充腋窝淋巴结的低转移率。     

贵州省720例乳腺癌HER-2的表达情况及抗HER-2治疗的回顾性分析

背景与目的：乳腺癌是严重威胁女性生命的恶性肿瘤之一,在我国汉族与其他少数民族乳腺癌的发病率及其HER-2基因表达差异成为学者关注的问题。该研究旨在分析贵州省乳腺癌HER-2基因表达的民族差异性,评价应用曲妥珠单抗行分子靶向治疗的临床疗效,探讨多种临床因素对贵州省乳腺癌患者生存预后的影响。方法：回顾性分析2007年1月—2013年12月在贵州医科大学附属肿瘤医院接受治疗的720例女性乳腺癌患者的随访情况,采用SPSS 17.0中的Kaplan-Meier法对患者进行生存分析,统计患者无病生存期(disease free survival,DFS)及总生存期(overall survival,OS),采用Log-rank检验进行因素间比较。采用Cox回归模式进行多因素检验,分析乳腺癌的独立预后因素。结果：入组的720例患者中,HER-2阴性表达520例(72.2%),HER-2阳性表达200例(27.8%)。200例HER-2阳性乳腺癌患者中,汉族177例(177/645,27.4%),少数民族23例(23/75,30.7%)。200例HER-2阳性乳腺癌患者中,行抗HER-2治疗37例(18.5%),未行抗HER-2治疗163例(81.5%),可分为治疗组及对照组。统计分析显示,治疗组与对照组的DFS和OS差异均有统计学意义(P=0.041和0.022)。Cox回归分析提示,雌激素受体(estrogen receptor,ER)和Ki-67是入组乳腺癌患者的独立预后因素(P=0.03和0.016),孕激素受体(progesterone receptor,PR和HER-2不是独立预后因素(P均>0.05);其中汉族乳腺癌患者的ER和Ki-67是独立预后因素(P=0.018和0.031),PR和HER-2不是独立预后因素(P均>0.05);少数民族乳腺癌患者的ER、PR、HER-2和Ki-67均不是独立的预后因素(P均>0.05)。结论：HER-2基因阳性表达不具有民族差异性。HER-2阳性患者应用曲妥珠单抗行抗HER-2治疗可明显改善预后,延长DFS及OS,但目前贵州省行抗HER-2治疗人群不足20%。本研究初步提示ER、Ki-67作为乳腺癌独立的预后因素具有民族差异性的趋势。     

ER、PR与C-erbB-2、Ki-67在乳腺癌中的表达及其临床意义

目的 探讨乳腺癌组织中ER、PR与C-erbB-2、Ki-67的表达及它们的相关性.方法 采用免疫组化检测,对356例乳腺癌患者ER、PR、C-erbB-2及Ki-67的表达、临床病理特征以及它们的相关性进行回顾性分析.结果 ER、PR、C-erbB-2及Ki-67的表达与淋巴结转移相关(P<0.05);乳腺癌组织分级...     

HER-2/neu（2+）腔面型乳腺癌的HER-2基因扩增与TopⅡα蛋白及临床特征的关联性分析

目的：分析HER-2基因扩增与腔面型HER-2/neu（2+）乳腺浸润性导管癌的临床病理特征及TopⅡα蛋白的关系。方法运用FISH检测手段对68例雌激素受体（ER）/孕激素受体（PR）阳性的腔面型HER-2/neu（2+）乳腺浸润性导管癌标本进行检测;应用免疫组化法（IHC）对68例标本进行TopⅡα蛋白表达检测。结果 FISH检测结果显示,68例标本中,HER-2基因扩增为13例（19.1%）;HER-2基因扩增在不同年龄、术后病理分期、淋巴结转移数目、Ki-67表达的患者之间差异无统计学意义;HER-2基因扩增病例中,TopⅡαⅠ级6例（46.2%）,Ⅱ级6例（46.2%）,Ⅲ级1例（7.7%）,Ⅳ级0例。TopⅡα蛋白表达情况在有无HER-2基因扩增的乳腺癌间差异无统计学意义（Z=1.353,P=0.176）。结论在HER-2/neu（2+）腔面型乳腺癌中,HER-2基因扩增与年龄、术后病理分期、淋巴结转移数目、Ki-67表达和TopⅡα蛋白表达无关。