MDR1和Anxa2在乳腺癌组织中的表达与侵袭转移的关系研究

探讨乳腺癌组织中多药耐药基因（MDR1）和膜联蛋白（Anxa2）表达的相关性及其与乳腺癌转移的关系。方法:应用荧光定量PCR的方法检测20例配对的乳腺导管内癌、100例乳腺浸润性导管癌、70例癌旁正常组织中MDR1和Anxa2 mRNA的相对表达情况。结果:MDR1 mRNA在乳腺导管内癌中的表达水平明显高于癌旁正常组织（P=0.005）,乳腺浸润性导管癌组织中mRNA的表达明显高于癌旁正常组织（P=0.017）和导管内癌（P=0.019 6）。Anxa2 mRNA在乳腺导管内癌中表达与癌旁正常组织相比无显著性差异（P=0.188 9）,但是在乳腺浸润性导管癌组织中的表达明显高于导管内癌（P=0.000 8）和癌旁正常组织（P<0.000 1）;MDR1和Anxa2 mRNA的表达升高均与患者出现淋巴结转移有关（P<0.01）;2种基因在乳腺浸润性导管癌中的表达呈正相关（P<0.000 1）。结论:在肿瘤进展过程中,MDR1和Anxa2 mRNA表达上调与乳腺癌的淋巴结转移有关,二者之间表达具有正相关提示肿瘤细胞的多药耐药的获得和肿瘤侵袭转移之间有着密切联系。      

Expression and clinical significance of E-cadherin, β-catenin and E-cadherin-catenins complex in breast cancer and precancerous lesions简

Objective： The aim of our study was to observe the expressions and clinical Significance of E-cadherin, β-catenin and E-cadherin-catenins complex in breast cancer and precancerous lesions, and analyze the relationship between the expressions and clinicopathological features in breast cancer. Methods： Immunhistochemical UltraSensitiveTM S-P method was employed to detect the expression of E-cadherin, β-catenin and E-cadherin-catenins complex in 128 cases of invasive ductal carcinomas, 89 cases of ductal carcinoma in situ and 57 cases of atypical ductal hyperplasia, 53 cases of usual ductal hyperplasia breast tissues were selected as a control group. The express of E-cadherin, β-catenin and their relationship with mult biological parameters including histological grade, region lymph node metastasis, distant metastasis and recurrence on files were also assessed. Results： （1） The staining patterns character of E-cadherin, β-catenin and E-cadherin-catenins complex： In UDH breast tissues, E-cadherin and a-catenin were expressed on cell membrane of ductal and acinic cells, showing cellular contour and border among cells. The abnormal expression of the three proteins occurred in breast invasive ductal carcinomas, ductal carcinoma in situ and atypical ductal hyperplasia tissues, showing cytoplasmic or nuclear staining, decrease and loss of cytomembrane staining. （2） The abnormal expression rates of E-cadherin, β-catenin and E-cadherin-catenins complex in invasive ductal carcinomas were 53.91%, 65.63% and 81.25%, which were significantly higher than that in ductal carcinoma in situ, atypical ductal hyperplasia, usual ductal hyperplasia tissues （P 〈 0.01）. Compared with usual ductal hyperplasia breast tissues group, the abnormal expression rates of E-cadherin, β-catenin and E-cadherin-catenins complex were significantly decreased （P 〈 0.01） in the breast cancer group. However, there was no significance of the abnormal expression rate between ductal carcinoma in situ and atypical ductal hyperplasia tissues groups （X2 = 0.76, P = 0.38; x2 = 0.14, P = 0.70; x2 = 0.81, P = 0.37; X2 = 2.19, P = 0.14） （P 〉 0.05）. （3） There was a significantly difference in the mean E-cadherin, β-catenin and E- cadherin-catenins complex frequency between estrogen receptor ＆ progesterone receptor positive IDC group and negative group, epidermal growth factor receptor type 2 （HER2/neu） positive and negative groups, Ki-67 proliferation index 〈 14% and 〉 14% groups, histological grade （I ＋ II） and grade III invasive ductal carcinomas groups, with lymph node metastasis, distant metastasis and recurrence groups （P 〈 0.05） and without groups （P 〈 0.05）. However, there was no difference in the mean E-cadherin, β-catenin and E-cadherin-catenins complex frequency between age （_〈 50 years vs 〉 50 years）, tumor diameter （〈 2 cm vs 〉 2 cm） （P 〉 0.05）. Conclusion： In breast cancer, the expressions of E-cadherin, β-catenin and E-cadherin-catenins complex are abnormally decreased and are correlated with pathology grade, differentiation disturbance and metastasis. E- cadherin and β-catenin may be as the predictors for prognosis. Combined detection may improve accuracy and sensitivity of predicting metastasis and prognosis of breast Cancer.     

uPA和HIF-1α在乳腺浸润性导管癌中的表达及其相关性

目的:探讨uPA和HIF-1α蛋白在乳腺浸润性导管癌组织中的表达及其相关性.方法:应用免疫组织化学法检测52例乳腺浸润性导管癌组织中uPA、HIF-1α蛋白表达.结果:乳腺浸润性导管癌组织中uPA蛋白阳性表达率为57.7%,HIF-1α蛋白阳性表达率为82.7%,uPA、HIF-1α蛋白表达之间存在显著正相关,r=0.498,P<0.01.结论:乳腺浸润性导管癌组织中存在uPA、HIF-1α的高表达,且两者之间的表达强度具有相关性.uPA蛋白可通过诱导HIF-1α蛋白的表达上调,成为促进乳腺癌侵袭、转移的途径之一.     

uPA和HIF-1α在乳腺浸润性导管癌中的表达及其相关性

目的：探讨uPA和HIF-1α蛋白在乳腺浸润性导管癌组织中的表达及其相关性。方法：应用免疫组织化学法检测52例乳腺浸润性导管癌组织中uPA、HIF-1α蛋白表达。结果：乳腺浸润性导管癌组织中uPA蛋白阳性表达率为57.7%,HIF-1α蛋白阳性表达率为82.7%,uPA、HIF-1α蛋白表达之间存在显著正相关,r=0.498,P〈0.01。结论：乳腺浸润性导管癌组织中存在uPA、HIF-1α的高表达,且两者之间的表达强度具有相关性。uPA蛋白可通过诱导HIF-1α蛋白的表达上调,成为促进乳腺癌侵袭、转移的途径之一。     

Loss of Expression and Aberrant Methylation of the CDH1 (E-cadherin) Gene in Breast Cancer Patients from Kashmir

Background: Aberrant promoter hypermethylation has been recognized in human breast carcinogenesis as a frequent molecular alteration associated with the loss of expression of a number of key regulatory genes and may serve as a biomarker. The E-cadherin gene (CDH1), mapping at chromosome 16q22, is an intercellular adhesion molecule in epithelial cells, which plays an important role in establishing and maintaining intercellular connections. The aim of our study was to assess the methylation pattern of CDH1 and to correlate it with the expression of E-cadherin, clinicopathological parameters and hormone receptor status in breast cancer patients of Kashmir. Materials and Methods: Methylation specific PCR (MSP) was used to determine the methylation status of CDH1 in 128 invasive ductal carcinomas (IDCs) paired with the corresponding normal tissue samples. Immunohistochemistry was used to study the expression of E-cadherin, ER and PR. Results: CDH1 hypermethylation was detected in 57.8% of cases and 14.8% of normal adjacent controls. Reduced levels of E-cadherin protein were observed in 71.9% of our samples. Loss of E-cadherin expression was significantly associated with the CDH1 promoter region methylation (p<0.05, OR=3.48, CI: 1.55-7.79). Hypermethylation of CDH1 was significantly associated with age at diagnosis (p=0.030), tumor size (p=0.008), tumor grade (p=0.024) and rate of node positivity or metastasis (p=0.043). Conclusions: Our preliminary findings suggest that abnormal CDH1 methylation occurs in high frequencies in infiltrating breast cancers associated with a decrease in E-cadherin expression. We found significant differences in tumor-related CDH1 gene methylation patternsrelevant to tumor grade, tumor size, nodal involvement and age at diagnosis of breast tumors, which could be extended in future to provide diagnostic and prognostic information.     

浸润性乳腺导管癌组织中Ezrin和钙粘素E的表达与淋巴结转移的关系

背景与目的：Ezrin是一种细胞骨架连接蛋白,参与调节肿瘤细胞的生长和转移。本研究通过检测Ezrin和钙粘素E（E-cadherin）在浸润性乳腺导管癌中的表达情况,探讨其在淋巴结转移中的意义。方法：采用免疫组织化学SP法检测60例浸润性乳腺导管癌病理组织切片中Ezrin和E-cadherin的表达。结果：Ezrin在37例无转移的癌组织中19例异常表达（51．35％）。23例有转移的癌组织中17例异常表达（73．91％）。E-cadherin在无转移的癌组织中15例异常表达（40．54％）。而在有转移的癌组织中15例异常表达（65．22％）。Ezrin异常表达与E-cadherin异常表达有显著的正相关性（r=0．898,P=0．038）。结论：Ezrin和E-cadherin与乳腺导管癌的浸润和转移密切相关,可以作为预测浸润性乳腺导管癌淋巴结转移的重要肿瘤标志物。     

Mucin expression in mucinous carcinoma and other invasive carcinomas of the breast.

To investigate mucin expression in breast cancer, immunohistochemical staining was performed on 30 mucinous carcinomas and 95 non-mucinous invasive carcinomas. MUC2 expression was detected in all mucinous carcinomas, but only in 11.1% of invasive ductal carcinomas, and in none of the invasive lobular carcinomas and medullary carcinomas. MUC1 is often expressed in invasive breast carcinoma, but not in medullary carcinoma. Strong cytoplasmic staining was seen in invasive ductal carcinoma, in contrast to surface membrane staining in mucinous carcinoma and intracytoplasmic vacuole staining in invasive lobular carcinoma. CA19-9 and CA50 expression in more than 25% of tumor cells was seen in 17.2 and 16.0% of invasive ductal carcinomas, respectively, but not in mucinous carcinomas. CA125 and human gastric mucin were rarely expressed in breast cancer, irrespective of histologic type.     

Clinicopathological significance of stromal myofibroblasts in invasive ductal carcinoma of the breast.

The purpose of this study was to investigate the distribution of CD34-positive fibroblasts and alpha-smooth muscle actin (alpha-SMA)-reactive myofibroblasts in the stroma of benign and malignant breast lesions and, secondly, to determine whether the presence of stromal myofibroblasts is associated with some of the clinicopathological characteristics of patients with invasive ductal carcinoma. The presence of stromal CD34-positive fibroblasts and myofibroblasts was investigated (as defined immunohistochemically) in 8 normal breast tissue samples, 58 invasive ductal carcinomas, 9 ductal carcinomas in situ and 16 specimens with benign lesions of the breast (fibroadenomas, ductal hyperplasias). We further studied the correlations between the presence of stromal myofibroblasts with 7 clinicopathological parameters in 58 invasive ductal carcinomas. The results indicated that the stroma of normal breast tissues contained CD34-positive fibroblasts. All benign breast lesions exhibited stromal CD34-positive fibroblasts. In contrast, the stroma of ductal carcinomas showed a complete loss of CD34-positive fibroblasts. alpha-SMA expression in stromal fibroblasts (myofibroblasts) was not detected in normal tissue samples or benign lesions except in 1 case of fibroadenoma, whereas positive myofibroblasts were found in 44.4% of ductal carcinomas in situ and 56.9% of invasive breast carcinomas. Comparison of clinicopathological parameters between invasive ductal carcinomas with and without stromal myofibroblasts revealed significant differences in lymph node metastasis, high histological grade and high microvessel density. These results suggest that CD34 loss and the presence of myofibroblasts favor the diagnosis of breast carcinoma. In invasive ductal carcinoma, the presence of stromal myofibroblasts correlated significantly with pathological parameters associated with a poor prognosis.     

iNOS在不同乳腺病理组织中的表达水平及其与肿瘤临床预后的相关性

目的:检测诱导型一氧化氮合酶（iNOS）在正常乳腺组织、不典型增生、原位癌以及浸润性乳腺癌组织中的表达水平,探讨其与浸润性乳腺癌临床相关病理指标及临床预后相关性。方法:收集148例不同乳腺病理组织（28例不典型增生、40例导管内癌及80例浸润性乳腺癌）以及20例正常乳腺组织,使用免疫组化SP法检测各组中iNOS的表达水平。分析浸润性乳腺癌中iNOS表达水平与肿瘤大小、腋窝淋巴结受累情况、TNM分期等临床病理指标,以及与临床预后的相关性。结果:iNOS在乳腺正常组织中未见阳性表达;而在乳腺不典型增生组织、原位癌组织及浸润性乳腺癌组织中阳性率分别为25.0%、52.5%及78.8%,各组间差异有统计学意义（均P<0.05）。在浸润性乳腺癌中,随着临床分期越晚及肿瘤直径越大,iNOS染色阳性率逐渐升高。在原位癌中iNOS染色阳性组5年无病生存率（61.9%）低于阴性组（84.2%）,差异有统计学意义（P<0.05）;而在浸润性乳腺癌中,iNOS染色阳性组5年无病生存率（63.5%）与阴性组（70.6%）无统计学差异（P>0.05）。结论:iNOS在乳腺癌发生的早期阶段（不典型增生）即已出现表达升高,其表达水平与临床分期与肿瘤直径相关,并影响原位癌患者预后。因此,iNOS可作为乳腺癌早期诊断及预后评估的潜在指标。     

c-myc, c-erbB-2, and Ki-67 expression in normal breast tissue and in invasive and noninvasive breast carcinoma.

c-myc, c-erbB-2, and Ki-67 expression was examined by immunohistochemistry in 11 normal breast tissues and 42 invasive and 14 noninvasive breast carcinomas. The c-myc product was detected in all breast carcinoma specimens and in 7 of 11 normal breast tissues. Invasive tumors stained more frequently with the anti-myc monoclonal antibody than did noninvasive tumors, while the level of expression in normal breast tissue was much less than that in breast cancer. Membrane staining of the c-erbB-2 protein was demonstrated in 29% (4 of 14) of noninvasive ductal carcinomas and in 45% (19 of 42) of invasive breast carcinomas. None of the 11 normal breast tissue samples was positive. The mean value of Ki-67-positive cells was 0.91 +/- 0.31% for normal breast tissue, 4.57 +/- 1.36% for noninvasive ductal carcinoma, and 12.76 +/- 2.18% for invasive breast cancer. In 42 invasive breast carcinomas, the expression of c-myc, c-erbB-2, and Ki-67 proliferation marker were compared with lymph node status, estrogen receptor status, progesterone receptor status, and age of patients at diagnosis. c-erbB-2 overexpression and Ki-67 overexpression were identified as the only factors associated with lymph node status. We concluded that they might be additional prognostic factors for breast carcinoma.     

ER阴性乳腺癌高表达乳腺癌干细胞标志物乙醛脱氢酶1

目的探讨85例乳腺浸润性导管癌中肿瘤干细胞标志物乙醛脱氢酶1(ALDH1)的表达情况及与临床病理特征的关系。方法采用免疫组化法检测乳腺组织芯片85例乳腺浸润性导管癌组织中ALDH1的表达并分析其临床意义。结果 ALDH1在雌激素受体(ER)阴性的乳腺癌中表达率(34.6%)显著高于ER阳性者(12.1%;P=0.024)。不同亚型乳腺癌中存在ALDH1表达的显著差异,其中三阴性乳腺癌中ALDH1的表达较高(50.0%,P=0.034)。ALDH1的表达在不同大小肿块的肿瘤中也存在差异,其中肿块小于2 cm的乳腺癌中ALDH1的表达率最高(50.0%;P=0.040)。而ALDH1的表达与患者年龄、肿瘤分级、淋巴结转移、疾病分期及PR、HER-2状态无关(P>0.05)。结论 ER阴性乳腺癌尤其是三阴性乳腺癌中ALDH1的表达率较高,提示ER阴性乳腺癌中存在较高比例的干细胞,进而有助于更好地理解其预后差的特点。     

Loss of LKB1 disrupts breast epithelial cell polarity and promotes breast cancer metastasis and invasion

Background

LKB1, also known as STK11, is a master kinase that serves as an energy metabolic sensor and is involved in cell polarity regulation. Recent studies have indicated that LKB1 is related to breast tumorigenesis and breast cancer progression. However, little work has been done on the roles of LKB1 in cell polarity and epithelial-mesenchymal transition in breast cancer. In this study, we tried to prove that loss of LKB1 disrupts breast epithelial cell polarity and causes tumor metastasis and invasion.

Methods

The relationships of LKB1 expression to clinic-pathological parameters and epithelial markers E-cadherin and high-molecular-weight -cytokeratin (HMW-CK) were investigated in 80 clinical breast cancer tissue samples and their paired normal control breast tissue samples by using immunohistochemistry. Then, the LKB1 expressions in metastatic and non-metastatic breast cancer cell lines were compared. The roles of LKB1 in cell polarity and epithelial-mesenchymal transition in breast cancer were determined by using immunofluorescence, western blot assay, and cell migration and invasive assays. Finally, the non-transformed human breast cell line MCF-10A was cultured in three dimensions to further reveal the role of LKB1 in breast epithelial cell polarity maintenance.

Results

Histopathological analysis showed that LKB1 expression level was significantly negatively correlated with breast cancer TNM stage, and positively correlated with ER/PR status and expression levels of E-cadherin and HMW-CK. Immunofluorescence staining showed that LKB1 was co-localized with E-cadherin at adheren junctions. In vitro analysis revealed that loss of LKB1 expression enhanced migration, invasion and the acquisition of mesenchymal phenotype, while LKB1 overexpression in MDA-MB-435 s cells, which have a low basal level of LKB1 expression, promoted the acquisition of epithelial phenotype. Finally, it was found for the first time that endogenous LKB1 knockdown resulted in abnormal cell polarity in acini formed by non-transformed breast epithelial cells grown in 3D culture.

Conclusion

Our data indicated that low expression of LKB1 was significantly associated with established markers of unfavorable breast cancer prognosis, such as loss of ER/PR, E-cadherin and HMW-CK. Knockdown of endogenous LKB1 gave rise to dysregulation of cell polarity and invasive phenotype of breast cancer cells.     

Diffuse growth pattern affects E-cadherin expression in invasive breast cancer

We investigated the correlations between growth patterns and E-cadherin expression by immunohistochemistry and the presence of mutations of exons 6-10 of the E-cadherin gene by PCR-SSCP, in 79 cases of invasive lobular and ductal breast cancer. E-cadherin expression showed a tendency to be lower in lobular than in ductal carcinomas (p=0.064). In 60% of lobular carcinomas the diffuse growth pattern and in 72% of ductal carcinomas the compact growth pattern predominated. E-cadherin expression was significantly lower in diffuse than in compact tumor area (p<0.001) and not related to carcinoma type when it was considered in tumor areas with either diffuse (p=0.278) or compact (p=0.128) growth pattern. No mutations were detected. In conclusion, loss of E-cadherin expression is related to an increase of diffuse growth pattern in both lobular and ductal types of breast cancer, and the differential proportions of growth patterns in both tumor types cause the tendency for lower E-cadherin expression in the lobular type.     

乳腺浸润性导管癌染色体1p36杂合性缺失的初步研究

目的 探讨染色体1p36可能存在的与非特殊类型乳腺浸润性导管癌发生、发展有关的肿瘤抑制基因,为发现和定位肿瘤抑制基因提供线索和热点位点.方法 选取1号染色体8个微卫星多态位点标志物,采用新鲜和石蜡组织基因组DNA抽提-PCR扩增-变性聚丙烯酰胺凝胶垂直电泳-银染法-全自动凝胶成像系统分析,检测80例浸润性导管癌及癌旁正常组织基因组DNA的杂合性缺失（LOH）频率.应用x2检验对实验结果进行综合分析.结果 80例浸润性导管癌中有45例（56.3％）至少在一个位点出现LOH,其中D1S1310微卫星位点频率最高,为35.7％（25/70）.结论 乳腺浸润性导管癌染色体1p36发生高频率LOH,提示1p36.23 ～ 33区间可能存在与乳腺癌发生、发展有关的抑癌基因.     

ERK1/2与ER和PR在乳腺病变中的表达及其意义

目的探讨ER、PR及ERK1、ERK2四种蛋白在乳腺疾病中的表达及意义。方法采用组织芯片技术和免疫组织化学方法（S-P方法）检测四种蛋白在乳腺良、恶性病变中的表达及意义。采用pearson χ^2检验构成比不同组别间的差异和spearman相关检验分析指标间相关趋势,用stata7.0软件包进行统计分析。结果ER表达阳性率在纤维腺病中最高,纤维腺瘤与浸润性导管癌比较,差异具有显著性（P〈0.05）;PR表达阳性率在纤维腺瘤中最高,纤维腺瘤与导管内乳头状瘤、浸润性导管癌比较,差异均具有显著性（P〈0.05）;ERK1、ERK2在纤维腺病和浸润性导管癌表达水平显著升高,纤维腺瘤与纤维腺病、浸润性导管癌比较,差异均具有显著性（P〈0.05）;ERK1与ERK2的表达具有显著性相关关系。结论纤维腺病与ERK1、ERK2、ER蛋白表达增高有关;导管内乳头状瘤主要与PR蛋白表达降低有关;浸润性导管癌与ER、ERK1、ERK2蛋白高表达和PR蛋白低表达有关,这三种蛋白标志可以成为评价纤维腺病与导管内乳头状瘤的转归及浸润性导管癌治疗有价值的指标。     

Altered expression of E-cadherin in breast cancer. patterns, mechanisms and clinical significance

Reduced cell adhesion brought about by altered surface expression of E-cadherin has been implicated in invasive and metastatic malignant growth. We investigated the patterns of immunohistochemical E-cadherin expression in 120 breast carcinomas. Furthermore, we analysed DNA from the same samples for loss of heterozygosity (LOH) using three separate microsatellite markers on chromosome 16q22.1. Finally, the clinical outcome was ascertained for 108 patients. 19% (18/97) of infiltrating ductal carcinomas showed complete loss of E-cadherin expression compared with 64% (9/14) of infiltrating lobular carcinomas. LOH was detected in 46% (24/52) of infiltrating ductal carcinomas and 89% (8/9) of infiltrating lobular carcinomas. In the infiltrating lobular carcinomas, LOH was associated with complete loss of cell membrane expression of E-cadherin, although a cytoplasmic expression pattern was evident. In contrast, this association was not seen in the infiltrating ductal carcinomas. In a multivariate analysis, loss of E-cadherin expression was shown to be a significant independent risk factor for a poorer disease-free survival (P=0.019), in particular in the node-negative subset of patients (P=0.029). Significance was also approached for breast cancer corrected survival (P=0.056). We conclude that different mechanisms are involved in the altered E-cadherin expression seen in different subtypes of breast carcinomas. Furthermore, we implicate loss of E-cadherin, regardless of the genetic causes, as an independent prognostic marker for disease recurrence, especially in node-negative breast cancer patients, irrespective of the histological type.