人类乳腺良恶性病变的SSTR2mRNA表达及其与类固醇受体相关性研究

目的了解人类良、恶性乳腺病变组织中生长抑素受体亚型2(SSTR2)mRNA的表达情况,并探讨其与雌激素受体(ER)、孕激素受体(PR)的相关性.方法收集23例乳腺癌、16例乳腺增生病和9例乳腺纤维腺瘤手术标本,采用多相寡核苷酸探针原位杂交法检测SSTR2mRNA表达,免疫组化法检测ER、PR状况,并用图像分析仪进行SSTR2mRNA相对含量测定.结果SSTR2mRNA在乳腺癌表达的阳性率(87%)和相对含量(0.47)均明显高于乳腺良性病变(64%,0.26)(P＜0.05).乳腺良性病变中SSTR2mRNA表达与ER呈正相关(P＜0.05);在乳腺癌中SSTR2mRNA表达与ER、PR均呈正相关(P＜0.05).结论SSTR2mRNA在乳腺良、恶性病变组织中普遍表达,恶性高于良性;SSTR2mRNA表达与ER、PR具有相关性,提示对ER阳性乳腺癌采用抗雌激素与SST类似物联合治疗的可行性.     

Prognostic value of ornithine decarboxylase and polyamines in human breast cancer: correlation with clinicopathologic parameters.

The polyamines putrescine, spermidine, and spermine and ornithine decarboxylase (ODC), the rate-limiting enzyme in their biosynthetic pathway, play an important role in cell proliferation, differentiation, and transformation. In the present study, we have analyzed polyamine concentrations and ODC activity in samples from benign breast diseases (n = 36), benign breast tissue adjacent to the primary carcinoma (n = 19), and breast carcinoma (n = 104). ODC activity in primary carcinoma was significantly higher (2.42 +/- 0.22 nmol CO2/h g; P < 0.001) than that found in benign breast (0.62 +/- 0.15 nmol CO2/h g) or in breast tissue adjacent to the primary carcinoma (0.52 +/- 0.16 nmol CO2/h g). The total polyamine content of breast cancer tissues was higher than in benign breast diseases (704.3 +/- 38.3 nmol/g wet weight versus 295.8 +/- 27.4 nmol/g wet weight) and correlated well with ODC activity (Pearson, r = 0.42; P < 0.001). ODC activity correlated with histological grade, peritumoral lymphatic or blood vessel invasion, S-phase fraction, and cathepsin D. Total polyamine concentration increased with S-phase fraction, cathepsin D, and aneuploidy. No significant correlation was found between ODC or polyamines and tumor size, lymph node involvement, or steroid receptor status. A major finding in our study was that ODC activity was an independent prognostic factor for recurrence and death. The results indicate that the estimation of ODC activity and polyamines in human breast carcinoma might be useful to determine tumor aggressiveness and suggest that ODC may have a potential value as both a prognostic factor and a chemoprevention target in human breast cancer.     

Oestrogen (ER) and progestin receptors (PR) in mammary tissue of the female dog: different receptor profile in non-malignant and malignant states

Oestrogen (ER) and progestin receptors (PR) were measured in cytosols from histologically normal mammary tissues (n = 30), and in benign (n = 59) and malignant mammary lesions (n = 49) from female dogs. Receptor levels greater than or equal to 5 fmol mg-1 protein were considered positive. The presence of histologically normal mammary epithelium within specimens of primary tumours was noticed as a factor that may cause false-positive receptor results. Receptor levels in non-malignant tissues, and the receptor status of primary cancers did not vary significantly with regard to the phase of oestrous cycle (anoestrus/metoestrus) or the influence of exogenous progestins. ER- or PR-positivity was more frequent and levels of both receptors were higher in 'normal' tissues and in benign lesions than in primary cancers (P less than 0.001). ER and PR levels were higher in benign lesions of dogs also developing malignant mammary tumours than in benign lesions of dogs that did not (P less than 0.02 and P less than 0.05, respectively). Regional and distant cancer metastases were frequently receptor-negative. In some dogs heterogeneity of receptor status was found between different sites of the same cancer. These findings indicate that in non-malignant mammary tissues of adult female dogs expression of the genes encoding ER and PR is common. In malignant tumours this property may become lost, in particular in advanced states of disease.     

Expression of epidermal growth factor receptor (EGFR) in non-affected and tumorous mammary tissue of female dogs

Summary Epidermal growth factor (EGFR), oestrogen (ER), and progestin (PR) receptor concentrations were determined by radioligand binding assay in non-affected mammary tissues (n = 13) and benign (n = 11) and primary/locally recurrent malignant proliferative mammary lesions (n = 45) and metastases (n = 19) in 65 female dogs.The number of specimens expressing EGFR was not significantly different among these tissues, but EGFR concentration was lower in metastases (P = 0.02) than in benign or primary/locally recurrent malignant lesions not mixed with non-affected mammary tissue. The presence of non-affected mammary tissue in primary cancer specimens was noticed as a factor that may influence results of receptor measurements. No relation was found between the expression of EGFR and that of ER or PR in non-affected or in tumorous mammary tissues.It was concluded that in the dog mammary gland EGFR expression is not associated with conditions of steroid receptor absence or biological agressiveness of neoplastic growth.     

乳腺增生与乳腺癌组织中雌激素受体、孕激素受体的表达差异及其临床意义

 目的　探讨乳腺增生及乳腺癌组织中雌激素受体（ER）、孕激素受体（PR）的表达差异及其临床意义。方法　采用免疫组织化学方法检测68例乳腺增生和168例乳腺癌标本中ER、PR的表达。结果　 乳腺癌患者ER表达水平明显高于乳腺增生患者（P＜0.05）,而PR在两组中的表达差异无统计学意义。绝经后乳腺癌患者ER表达水平中位值为30 %,明显高于绝经后乳腺增生患者的10 %（P＜0.05）,而在绝经前两组患者ER表达水平差异无统计学意义。浸润性小叶癌组织内PR的表达明显高于浸润性导管癌等其他类型,差异有统计学意义（P＝0.005）。结论　ER、PR的表达能够较好地反映乳腺疾病的病理生物学特征。     

Tip30 deletion in MMTV-Neu mice leads to enhanced EGFR signaling and development of estrogen receptor-positive and progesterone receptor-negative mammary tumors

Estrogen receptor-positive and progesterone receptor-negative (ER+/PR-) breast cancers account for 15% to 25% of all human breast cancers and display more aggressive malignant characteristics than ER+/PR+ cancers. However, the molecular mechanism underlying development of ER+/PR- breast cancers still remains elusive. We show here that Tip30 deletion dramatically accelerated the onset of mammary tumors in the MMTV-Neu mouse model of breast cancer. The mammary tumors arising in Tip30(-/-)/MMTV-Neu mice were exclusively ER+/PR-. The growth of these ER+/PR- tumors depends not only on estrogen but also on progesterone despite the absence of detectable PR. Tip30 is predominantly expressed in ER+ mammary epithelial cells, and its deletion leads to an increase in the number of phospho-ERα-positive cells in mammary glands and accelerated activation of Akt in MMTV-Neu mice. Moreover, we found that Tip30 regulates the EGFR pathway through controlling endocytic downregulation of EGFR protein level and signaling. Together, these findings suggest a novel mechanism in which loss of Tip30 cooperates with Neu activation to enhance the activation of Akt signaling, leading to the development of ER+/PR- mammary tumors.     

Relationships among serum CA15-3 tumor marker, TNM staging, and estrogen and progesterone receptor expression in benign and malignant breast lesions

Serum tumor marker CA15-3 is widely used in follow-up for assessment of breast cancer prognosis. The aim of this study was to evaluate levels among healthy females and patients, to assess differences with tumor stage and grade, and to determine the relationship with estrogen and progesterone receptor expression. One hundred and thirty six Jordanian females were enrolled in this study: Forty-five were healthy females; seventy-two were diagnosed with breast cancer and nineteen diagnosed with benign breast lesions. Elevated serum CA15-3 level was significantly observed among breast cancer patients (37.95±6.65) compared to both healthy (14.97±0.8) and benign females (12.30±1.55), but no significant association was detected between serum CA15-3 level and age of cancer onset, menarche age, menopause age, parity and BMI. Decreased CA15-3 level was significantly associated with hormone therapy and oral contraceptive consumption among breast cancer patients. Significantly elevated CA15-3 serum levels were found among grade II, III and stage II and III breast cancer females compared to normal healthy females. Elevated CA15-3 serum levels were also found among ER+/PR+ (54.242±7.89) and ER+/PR- (37.08±8.22) compared to healthy control females.     

A functional polymorphism of TGFBR2 is associated with risk of breast cancer with ER(+), PR(+), ER(+)PR(+) and HER2(-) expression in women

Little is known about the correlation between TGFBR2 G-875A and breast cancer risk. Moreover, the associations of the expression of estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor-2 (HER2) in breast cancer tissues with the TGFB1 C-509T, T+29C and TGFBR2 G-875A polymorphisms remain to be determined. In this study, we genotyped for TGFB1 C-509T, T+29C and TGFBR2 G-875A in fresh surgically resected tissues (n=82) and archived paraffin-embedded specimens (n=88) from 170 patients with breast cancer, as well as peripheral blood samples from 178 cancer-free female individuals. Evaluation of ER, PR and HER2 expression was performed using immunohistochemical staining. Logistic regression analysis was carried out to determine the risk of breast cancer by calculating the odds ratios (ORs) and their 95% confidence intervals (CIs). As a result, no difference was observed in the TGFB1 C-509T, T+29C genotype and allele frequencies between patients and controls. However, the frequency of the TGFBR2 -875A allele was marginally higher in cancer-free female individuals than that of women with breast cancer (24.2 vs. 17.9%, P=0.05). Notably, when stratification was performed by ER, PR and HER2 expression, the TGFBR2 -875A allele was found to correlate significantly to a decreased risk of breast cancer with ER(+) (OR=0.57, 95% CI 0.35-0.92), PR(+) (OR=0.54, 95% CI 0.34-0.88), ER(+)PR(+) (OR=0.55, 95% CI 0.33-0.92) and HER2(-) (OR=0.55, 95% CI 0.34-0.88) under a dominant genetic model. In conclusion, this is the first study to suggest that the TGFBR2 -875A allele modifies predisposition to breast cancer with an expression of ER(+), PR(+), ER(+)PR(+) and HER2(-).     

ER、PR和HER2联合检测对乳腺癌脑转移瘤发生的预测价值

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.     

Oral contraceptive (OCP) use increases proliferation and decreases oestrogen receptor content of epithelial cells in the normal human breast

The effect of ingestion of oral contraceptives (OCP) on cell proliferation and oestrogen (ER) and progesterone receptor (PR) expression of the epithelial cells of the normal human breast was compared with findings in controls not taking OCPs. Histologically normal breast tissue was removed during operation for fibroadenoma or reduction mammoplasty in 216 women whose mean age was 28.1 +/- 8.5 years (+/- SD range 14-53 years). During natural cycles the mean proportion of cells expressing ER was 3.94 +/- 3.71 (% mean +/- SD, range 0-20.8, n = 51), while of those expressing PR it was 12.1 +/- 7.1% (range 3.0-36.1, n = 47). There was a significant decline in ER during the menstrual cycle [p = 0.001 by multiple linear regression (MLR)], but there was no significant change in the proportion which expressed PR. The mean proportion of proliferating cells (LI) was 2.50 +/- 2.42 (range 0-11.5, n = 147). There was a significant increase of LI during the cycle (p = less than 0.001, MLR) and a significant inverse relationship between LI and ER (r = -0.29, p less than 0.01). Use of the OCP significantly reduced the number of cells which expressed ER and increased the LI earlier in the cycle. No effect of OCP use on the number of PR+ cells was detectable. We conclude that significant changes in the proportions of ER+ and proliferating cells occur during natural menstrual cycles. These changes are perturbed by ingestion of OCPs, so that there is greater suppression of ER and a longer period of high proliferation during the menstrual cycle. These results may explain the relationship between OCP use and the possible risk of breast cancer.     

乳腺癌血清VEGF水平与癌组织中VEGF和COX-2表达及微血管密度的关系

目的探讨乳腺癌患者血清血管内皮生长因子(sVEGF)水平与乳腺癌血管生成的关系。方法采用酶联免疫吸附试验(ELISA)检测68例乳腺癌、35例乳腺良性病变和20例健康女性的sVEGF水平,免疫组化S-P法检测相应乳腺癌组织中VEGF、环氧合酶-2(COX-2)及微血管密度(MVD)表达水平,并分析sVEGF水平与VEGF、COX-2及MVD表达的关系。结果(1)健康女性组、乳腺良性病变组和乳腺癌组sVEGF浓度中位数分别为105.93、150.82和306.51 pg/ml,乳腺癌组明显高于健康女性组。(2)乳腺癌组VEGF和COX-2表达阳性率分别为67.6%和44.1%,乳腺良性病变组VEGF和COX-2表达阳性率分别为42.9%和11.4%,两组间差异有统计学意义(P值分别为0.015和0.002)。(3)乳腺癌患者sVEGF水平与癌组织中VEGF、COX-2及MVD表达均呈正相关。(4)乳腺癌患者中,VEGF表达阳性组COX-2阳性率(65.21%)明显高于VEGF表达阴性组(18.18%); COX-2表达阳性组MVD(22.94±5.51)明显高于COX-2表达阴性组(10.30±4.42)。结论乳腺癌患者sVEGF水平明显增高于健康女性,并与癌组织中VEGF、COX-2及MVD表达呈正相关。     

Expression of Cyclin E and Its Relationship with the Prognosis of Patients with Breast Cancer

Objective： To investigate the expression of cyclin E in breast cancer tissues and its relationship with prognosis of the patients with breast cancer. Methods： The expression of cyclin E, HER-2/neu, nm23-H1 and actin was detected in 80 breast cancer tissues and 18 benign breast tumor tissues by immunohistochemical methods. The relationship between cyclin E and the remaining genes or the clinical data of the patients with breast cancer was analyzed. Results： The over expression rate of cyclin E in malignant tissues was obviously higher than that in benign tumor tissues （P〈0.01）. The over expression of cyclin E in later stage of disease was higher than that in early stage of disease （P〈0.05）. The expression of cyclin E in ER positive tissues was lower than that in ER negative tissues （P〈0.05）. The expression of cyclin E in PR positive tissues and PR negative tissues had no significant difference （P〉0.05）. The expression of cyclin E in HER-2/neu positive tissues was higher than that in HER-2/neu negative tissues （P〈0.05）. And the expression of cyclin E in ER, PR and HER-2/neu all positive tissues was much higher （P〈0.01）. There was no significant difference in the expression of cyclin E between nm23-H1 positive tissues and nm23-H1 negative tissues （P〉0.05）. The expression of cyclin E in actin positive and continuous distribution tissues was lower than that in actin negative or discontinuous distribution tissues （P〈0.05）. Conclusion： The expression of cyclin E has a strong correlation to the prognosis of the patients with breast cancer.     

Expression of aldehyde dehydrogenase 1 as a marker of mammary stem cells in benign and malignant breast lesions of Ghanaian women

BACKGROUND:

Breast cancers that are negative for the estrogen receptor (ER), the progesterone receptor (PR), and the HER2 (human epidermal growth factor receptor 2) marker are more prevalent among African women, and the biologically aggressive nature of these triple‐negative breast cancers (TNBCs) may be attributed to their mammary stem cell features. Little is known about expression of the mammary stem cell marker aldehyde dehydrogenase 1 (ALDH1) in African women. Novel data are reported regarding ALDH1 expression in benign and cancerous breast tissue of Ghanaian women.

METHODS:

Formalin‐fixed, paraffin‐embedded specimens were transported from the Komfo Anoyke Teaching Hospital in Kumasi, Ghana to the University of Michigan for centralized histopathology study. Expression of ER, PR, HER2, and ALDH1 was assessed by immunohistochemistry. ALDH1 staining was further characterized by its presence in stromal versus epithelial and/or tumor components of tissue.

RESULTS:

A total of 173 women contributed to this study: 69 with benign breast conditions, mean age 24 years, and 104 with breast cancer, mean age 49 years. The proportion of benign breast conditions expressing stromal ALDH1 (n = 40, 58%) was significantly higher than those with cancer (n = 44, 42.3%) (P = .043). Among the cancers, TNBC had the highest prevalence of ALDH1 expression, either in stroma or in epithelial cells. More than 2‐fold higher likelihood of ALDH1 expression was observed in TNBC cases compared with other breast cancer subtypes (odds ratio = 2.38, 95% confidence interval 1.03‐5.52, P = .042).

CONCLUSIONS:

ALDH1 expression was higher in stromal components of benign compared with cancerous lesions. Of the ER‐, PR‐, and HER2‐defined subtypes of breast cancer, expression of ALDH1 was highest in TNBC. Cancer 2013. © 2012 American Cancer Society.     

乳腺癌组织中IL-8和MVD的表达与预后关系

目的:检测乳腺癌组织中IL-8和微血管密度(microvessel density,MVD)表达,探讨其与临床病理学因子及生物学因子的关系。方法:采用免疫组化SP法检测乳腺癌组织中IL-8、ER、PR、VEGF和CD105的表达。结果:1)103例乳腺癌组织中,IL-8阳性表达率为79.6%(82/103),正常及良性组织IL-8阳性率为13.8%(4/29),两者相比差异有统计学意义,P=0.000。2)MVD计数值范围为0~17.67,中位数为5.33。3)IL-8与VEGF和MVD表达均呈现正相关性,rs值分别为0.332和0.425,P值均为0.000。4)IL-8与淋巴结转移及临床分期有关,P值分别为0.002和0.024。5)IL-8与ER、PR、肿瘤大小及病理类型无关,P值分别为0.449、0.467、0.921和0.145。6)IL-8表达和MVD与乳腺癌预后有关,P值分别为0.006和0.002。结论:IL-8表达和MVD与影响乳腺癌患者预后的生物学因素相关,IL-8和MVD高表达,预后差,可作为判断乳腺癌预后指标。     

乳腺癌组织中PSA mRNA和VEGF mRNA的表达及其关系

目的探讨前列腺特异抗原(PSA)mRNA和血管内皮细胞生长因子(VEGF)mRNA在乳腺癌组织中的表达及其关系。方法采用半定量逆转录聚合酶链式反应(RT-PCR)检测35例乳腺癌、12例癌旁乳腺组织和10例乳腺纤维腺瘤组织中的表达,免疫组化检测35例乳腺癌组织中ER、PR的表达,分析PSA mRNA和VEGFmRNA表达之间的关系。结果PSA mRNA在乳腺癌组织中的表达水平明显低于癌旁乳腺组织和乳腺纤维腺瘤组织,差异有显著性(P值均=0.00)。VEGF 121、165mRNA在乳腺癌中的表达水平明显高于癌旁乳腺组织和乳腺纤维腺瘤组织的表达(P值均=0.00)。ER、PR阳性表达的乳腺癌组织中PSA mRNA表达高于ER、PR阴性者,差异有显著性(P=0.001和0.004)。PSA mRNA表达阳性者VEGF 121、165mRNA表达水平明显低于PSA mRNA表达阴性者(P=0.034、0.026)。结论PSA mRNA在乳腺癌组织中的表达下调,但其表达受ER、PR的调控,而且其可能具有抑制乳腺肿瘤血管生成的作用。     

结直肠癌雌激素受体及孕激素受体的定量研究

背景与目的许多研究表明结直肠癌与雌激素相关,结直肠癌组织中表达雌激素受体(estrogenreceptor,ER)、孕激素受体(progesteronereceptor,PR),但多采用免疫组化方法检测,且结果不一,而ER.PR的定量研究不多。本研究拟定量测定结直肠癌组织及正常组织的ER,PR表达水平,并探讨它们之间的关系及与结直肠癌患者临床病理参数的关系。方法应用受体放射配基结合分析法(radioligandbindingassay,RBA)定量测定45例结直肠癌组织及结直肠正常组织的胞浆及胞核ER、PR的水平。结果45例标本结直肠正常组织及癌组织都表达ER、PR,胞浆ER表达癌组织高于正常组织,分别为7.96±3.69fmol/mgprotein和4.34±2.84fmol/mgprotein,(P<0.01);胞浆PR表达癌组织高于正常组织,分别为3.89±2.64fmol/mgprotein和2.50±1.73fmol/mgprotein,(P<0.01);胞核ER表达癌组织高于正常组织,分别为18.42±8.30fmol/mgprotein和11.24±5.44fmol/mgprotein,(P<0.01);胞核PR表达癌组织高于正常组织,分别为9.36±5.90fmol/mgprotein和7.84±7.41fmol/mgprotein,(P<0.05)。癌组织胞浆及胞核的ER表达与PR表达呈正相关,(P<0.01);正常结直肠组织胞浆ER表达与PR表达呈正相关,(P<0.01),而胞核内两者不相关,(P>0.05)。结直肠癌组织ER表达与患者年龄相关,大于45     

乳腺癌组织中bag-1、ER和PR的表达及意义

目的检测bag-1,ER和PR在乳腺癌组织中的表达与分布情况,探讨bag-1、ER和PR的表达水平在乳腺癌发病、早期诊断方面的价值。方法采用免疫组化SABC法观察了100例乳腺癌与35例乳腺良性肿瘤及10例正常乳腺组织的石蜡标本切片中bag-1,ER和PR的表达与分布情况。结果bag-1在乳腺癌组织中,乳腺良性肿瘤中,正常乳腺组织中阳性表达率分别为85.0%,11.5%,10.0%,差异明显(P<0.05)。ER在乳腺癌组织中,乳腺良性肿瘤中,正常乳腺组织中阳性表达率分别为61.0%,28.6%,30.0%,差异明显(P<0.05)。PR在乳腺癌组织中,乳腺良性肿瘤中,正常乳腺组织中阳性表达率分别为64.0%,31.5%,30.0%,差异明显(P<0.05)。结论在乳腺癌发病过程中,bag-1,ER和PR可能起着重要的作用,同时检测bag-1、ER和PR的表达与分布情况,在乳腺癌的早期诊断方面有一定价值。     

ER(-)与ER(+)乳腺癌患者临床特点及生物学特性比较

目的 比较分析ER( -)与ER(+)乳腺癌患者临床特点及生物学特性的差异.方法 回顾性分析我科收治的683例经手术证实的乳腺癌患者的临床资料.683例乳腺癌患者按ER状态分为2组,其中ER( -)组314例,ER(+)组369例.结果 ER( -)组中淋巴结转移比例明显大于ER(+)组(P＜0.05),ER( -)组肿瘤核心最大横径明显大于ER(+)组(P＜0.05),ER( -)组患者年龄及BMI明显低于ER(+)组(P＜0.05),ER( -)组绝经患者比例及肥胖患者比例明显小于ER(+)组(P＜0.05),ER( -)组PR( -)比例明显大于ER(+)组(P＜0.05).结论 ER( -)乳腺癌的恶性程度及转移率均高于ER(+)乳腺癌患者,绝经前非肥胖女性为ER( -)乳腺癌高危人群.     

血清TPS表达与乳腺癌临床病理特征相关性的研究

目的:研究组织多肽特异性抗原(TPS)在乳腺癌患者血清中的表达与乳腺癌临床病理特征的关系.方法:用ELISA 法检测53例乳腺癌患者、50例乳腺良性疾病患者及50例正常女性的血清TPS水平;SP法检测ER、PR、c-erbB-2和Ki-67.结果:乳腺癌患者血清TPS水平及检测阳性率均明显高于乳腺良性疾病和正常对照组(t=-9.275,P=0.001;t=-11.25,P=0.001).TPS阳性率和表达水平均随着临床分期的进展而升高.53例原发性乳腺癌中,肿块直径≤2 cm组与＞2 cm组的TPS差异无统计学意义;ER/PR阴性组与阳性组血清TPS水平差异有统计学意义(t=3.072,P=0.003; t=2.75,P=0.006);c-erbB-2阴性组与阳性组血清TPS水平差异有统计学意义,t=-3.981,P=0.001.血清TPS表达与ER、PR、c-erbB-2和Ki-67相关性显著(r=-0.512,P=0.001; r=-0.624,P=0.001 ;r=0.441,P=0.001 ;r=0.514,P=0.001); TPS表达均与腋淋巴结转移有关,与转移数目无明显关系.结论:TPS可作为乳腺癌血清肿瘤标志.TPS表达与乳腺癌腋淋巴结转移、ER、PR、c-erbB-2 和Ki-67有关,提示TPS可能可以作为乳腺癌评估及预后判断的指标.     

激素受体和人表皮生长因子受体2的表达与改良根治术后淋巴结阳性乳腺癌患者预后的关系

目的 探讨雌激素受体(ER)、孕激素受体(PR)和人表皮生长因子受体2(Her-2)的表达情况与行改良根治术后腋窝淋巴结阳性乳腺癌患者预后的关系.方法 收集835例行改良根治术后腋窝淋巴结阳性乳腺癌患者的临床和随访资料.根据ER、PR和Her-2的免疫组化检查结果,将患者分为Rec-/Her-2-(三阴性)组、Rec-/Her-2+组、Rec+/Her-2+组和Rec+/Her-2-组,比较其局部区域复发率、远处转移率、无瘤生存率和总生存率.结果 835例患者中,三阴性组141例,Rec-/Her-2+组99例,Rec+/Her-2+组157例,Rec+/Her-2-组438例.Rec+/Her-2-患者的5年局部区域复发率为6.2%,低于其他患者(12.9%,P=0.004).与受体阳性组(Rec+/Her-2+和Rec+/Her-2-)比较,受体阴性组(Rec-/Her-2-和Rec-/Her-2+)有较高的5年远处转移率(26.4%和19.7%,P=0.0008)、较低的5年无瘤生存率(66.7%和75.6%,P=0.0001)和较低的5年总生存率(71.4%和84.2%.P=0.0000).多因素Cox回归分析结果显示,激素受体和Her-2的表达状态是乳腺癌患者局部区域复发、远处转移、无瘤生存和总生存的独立影响因素(均P<0.05),Rec+/Her-2-患者的局部区域复发风险低,受体阴性患者发生远处转移和死亡的风险高.结论 ER、PR和Her-2是改良根治术后腋窝淋巴结阳性乳腺癌患者的独立预后因素.