内质网分子伴侣GRP78在乳腺癌中的表达及其预后意义

目的 探讨乳腺癌中GRP78的表达及其与乳腺癌临床、病理特征的相关性及其预后意义.方法 采用免疫组化Envision法检测了172例乳腺癌石蜡标本中GRP78的表达并对其表达与乳腺癌患者的月经状况、肿瘤大小、淋巴结转移状况、病理类型、组织学分级、激素受体状况、Her-2、Ki-67表达状况等临床、病理特征的相关性以及与预后的关系进行统计分析.结果 在172例手术切除的乳腺癌标本中,GRP78普遍阳性表达于肿瘤细胞,其中71例(41.28％)为强表达,101例(58.72％)为弱表达.GRP78的表达与乳腺癌患者的月经状况、淋巴结转移状况、病理类型、组织学分级、激素受体状况、Ki-67表达状况等临床、病理特征无相关性(P＞0.05);其在T3、Her-2阳性乳腺癌患者中的表达显著高于在T1、T2和Her-2阴性患者中的表达(P＜0.05).生存分析结果表明,GRP78强表达患者的无病生存时间和总生存时间较弱表达患者差,差异有统计学意义(P＜0.05).Cox回归分析表明,GRP78的表达状况是乳腺癌患者无病生存时间的独立预后因素(P＜0.05),但不是总生存时间的独立预后因素(P＞0.05).结论 GRP78普遍阳性表达于乳腺癌,其表达增强,预示患者预后不良,GRP78的表达状况对判断乳腺癌患者的预后具有一定的参考价值.

Expression of endoplasmic reticulum chaperone GRP78 in breast cancer and its prognosis significance

Objective To investigate the expression of GRP78 in breast cancer,the relationships among the expression and the clinicopathological characteristics,prognosis were also investigated.Methods The expression of GRP78 was detected in 172 paraffin-embedded breast cancer samples with immunohistochemistry Envision method,the relationships among the expression and the clinicopathological characteristics,prognosis were investigated.Results Positive expression of GRP78 is common in breast cancer.Strong expression of GRP78 was detected in 71 cases (41.28％),and weak expression was detected in 101 cases (58.72％).GRP78 expression wasn't associated with the clinicopathological characterristics except T stage and Her-2 status.Univariate analysis (log-rank test) showed that GRP78 expression correlated with disease free survival and overall survival significantly.Patients with strong GRP78 expression had poorer prognosis compared to those with weak GRP78 expression(P ＜ 0.05).Multivariate analysis utilizing Cox regression analysis showed that GRP78 is an independent biomarker of disease free survival (P ＜ 0.05),but not an independent biomarker of overall survival (P ＞ 0.05).Conclusions Positive expression of GRP78 is common in breast cancer and strong expression is associated with poorer survival.