Caveolin-1在乳腺癌间质中的表达及与预后的关系

目的 检测Cav-1在乳腺癌间质中的表达,探讨其与临床病理学指标,乳腺癌分子亚型及与三阴型乳腺癌预后的关系.方法 选取258例有完整随访资料的乳腺癌切除标本,用免疫组织化学方法 检测间质中CAF细胞的Cav-1表达,与肿瘤临床T分期、病理分级、淋巴结转移情况及肿瘤细胞分子标记物(ER、PR、HER-2、P53、PCNA)的表达情况进行相关性分析,同时分析在Luminal A型、Luminal B型、HER-2型和三阴型中Cav-1的差异性表达,并在三阴型乳腺癌中根据Cav-1的表达进行生存分析.结果 258例乳腺病例中,78例间质Cav-1的阴性/微弱阳性表达,94例中等阳性表达,86例强阳性表达.肿瘤分期越高,Cav-1的表达的阳性率越低,T1、T2及T3~T4各组之间差异有显著性意义(P<0.05).有淋巴结转移的肿瘤比无淋巴结转移的肿瘤Cav-1表达水平低,二者具有显著性差异(P<0.05).与患者年龄、肿瘤大小、ER、PR和HER-2的状态无关.三阴型乳腺癌与Luminal A型、B型、HER-2型相比, Cav-1的表达明显降低(P<0.05),而A型、B型、HER-2型之间无明显差异.三阴型乳腺癌间质中Cav-1(-)、Cav-1(+)、Cav-1(++)三组生存率差异有显著性(P<0.05),Cav-1的表达缺失是三阴型乳腺癌预后差的独立预后指标(HR=1.583 95%CI=1.031-2.431,P<0.05).结论 Cav-1表达水平随着临床分期的增高而降低;间质中Cav-1是三阴型乳腺癌的独立预后指标,Cav-1的低表达与预后差密切相关.

Expression of caveolin-1 in cancer-associated fibroblasts as a prognostic indicator in breast cancer

Objective To investigate the stromal caveolin-1(Cav-1) expression and its association with clinicalpathologic parameters, molecular subtypes of breast cancer and its prognostic significance.Methods Cav-1 expression was detected in the stroma of 258 breast cancer patients with at least 10 years of follow-up in IHC.Three groups were divided according to the staining strength (weak-, moderate+ and strong ++).Differential expression was analyzed in the light of clinical stage, pathology grade, lymphatic metastasis and the expression of molecular markers (ER,PR,HER-2,P53 and PCNA).Further analysis was performed in Luminal A, Luminal B, HER-2 and triple negative subtypes of breast cancer.Results Overexpression of stromal Cav-1 in breast cancer was associated with early stage(P=0.014) and no lymph node metastasis(P=0.011).The expression had no relationship with histological grade,ER status,PR status,HER-2 status, p53 status and PCNA status.Stromal Cav-1 expression in TN breast cancer was significantly lower than that in Luminal A, Luminal B, HER-2 molecular subtypes (P=0.014,0.035 and 0.047 respictively).Furthermore, stromal expression of Cav-1 was significantly correlated with the progression-free survival(P=0.033) and overall survival rate(P=0.031).Conclusion The absence or reduction of Cav-1 expression in stromal CAFs of invasive breast cancer would predict the poor prognostic outcome.Stromal Cav-1 expression would become a prognostic indicator.