富集AT序列的特异性结合蛋白1和B细胞淋巴瘤/白血病2在浸润性乳腺癌中的表达及其临床意义

目的检测富集AT序列的特异性结合蛋白1(SATB1)、B细胞淋巴瘤/白血病2(Bcl-2)在乳腺癌组织中表达的情况,探讨其与临床病理因素的关系及对乳腺癌预后的临床意义。方法应用免疫组织化学方法(SP法)检测84例乳腺癌组织中SATB1、Bcl-2和雌激素受体(ER)、孕激素受体(PR)的表达情况并分析SATB1、Bcl-2与乳腺癌临床病理因素及预后的关系。定性资料采用χ2检验、Mann-WhitneyU秩和检验和Kruskal-WallisH秩和检验;两组间的相关性采用Spearman秩相关分析;生存分析采用Kaplan-Meier法(简称K-M法)、Log-Rank检验和COX模型分析法。结果 SATB1在乳腺癌组织中的阳性表达率明显高于乳腺癌旁组织(χ2=30.03,P=0.00);Bcl-2在乳腺癌组织中的阳性表达显著低于乳腺癌旁组织(χ2=5.01,P=0.03)。SATB1蛋白在乳腺癌中的阳性表达与患者年龄、肿瘤大小和组织学类型无关(P0.05),但随组织学分级、临床分期的增加及淋巴结转移而升高(P0.05);Bcl-2的表达与组织学分级和淋巴结转移有关(P0.05),随着组织学分级升高和淋巴结的转移而表达下降。乳腺癌组织中SATB1与ER、PR表达有相关性(r=-0.31,P=0.01;r=0.29,P=0.01),与Bcl-2的表达无相关性(r=-0.21,P=0.05);Bcl-2与ER、PR表达无相关性(r=0.09,P=0.40;r=0.17,P=0.12)。SATB1表达与乳腺癌患者的预后有关(χ2=32.55,P=0.00);SATB1、ER、组织学分级和是否淋巴结转移是影响乳腺癌预后的4个独立因素(P0.05)。结论 SATB1可能提示乳腺癌发展的恶性进程,其高表达提示乳腺癌患者预后不良,有望成为一个新的相对独立的乳腺癌预后预测指标。Bcl-2高表达提示乳腺癌表现好的生物学行为。

Expressions of SATB1 and Bcl 2 in invasive breast cancer and their clinical significance

Objective To study the expressions of SATB1 （special AT-rich sequence-binding protein-1） and Bcl-2 （B cell lymphoma/leukemia-2） in invasive breast cancer, their relationship with clinical pathological parameters and their clinical significance. Methods The expressions of SATB1, Bcl-2, estrogen receptor （ER） and progesterone receptor （PR） were studied in 84 invasive breast cancer samples using SP immunohistochemistry （IHC） and the relationship of SATB1 and Bcl-2 with clinical pathological parameters and prognosis was analyzed. Chi square test,Mann-Whitney U test and Kruskal- Wallis H test were used for qualitative data. Spearman test was used to analyze the correlation between groups. Kaplan -Meier method, Log-rank test and COX model analysis were used for survival analysis. Result The expression of SATBI in breast cancer was significantly higher than that in adjacent normal tissue （X2 =30.03 ,P=0.00）. The expression of Bcl-2 in breast cancer was significantly lower than that in adjacent normal tissue（x2 =5.03 ,P=0.03）. The expression of SATB1 was not related with the age, tumor size and histological type （P〉 0.05）, but increased with the increase of the histological grade, clinical stage and lymph node metastasis（P〈0.05）. The expression of Bcl-2 was related with histological grade and lymph node metastasis （P〈0.05）, but descended with increase of histological grade and lymph node metastasis. The expression of SATB1 was correlated with ER （r=-0.31,P=0.01） and PR（r= -0.29,P=0.01）, but was not correlated with Bcl-2 （r= -0.21 ,P=0.05）. Bcl-2 was not correlated with ER （r=0.09,P=0.40） and PR（r=0.17,P=0.12）. SATB1 was statistically correlated with the prognosis （X2= 32. 55,P= 0. 00）. SATB1, histological grade, lymph node metastasis and ER were independent prognostic factors of invasive breast cancer （P〈0.05） . Conclusion SATB1 may be related to malignant process of breast cancer. Overexpression of SATB1 indicates poor prognosis in breast cancer patients. SATB1 may become a new independent prognostic factor for breast cancer. High expression of Bcl-2 indicates good biological behaviour of breast cancer.