Array-CGH筛选的FOXM1在乳腺导管内癌的表达和预后价值

目的 探讨基于微阵列比较基因组杂交技术(Array-CGH)筛查的FOXM1对乳腺导管内癌(DCIS)预后的预测价值.方法 收集DCIS和乳腺浸润性导管癌的石蜡标本共101例,通过免疫组化检测基于Array-CGH筛查的FOXM1的表达情况,评估FOXM1对预测导管内癌预后的作用.结果 免疫组化检测到FOXM1在DCIS的阳性率为59.4％ (60/101),其表达在单纯DCIS低于伴有微浸润的DCIS(DCIS-MI)(12.2％ vs 31.7％,P =0.032),但与年龄、绝经状态、肿瘤大小、腋窝淋巴结状态、激素受体状态、HER2状态无明显关系.中位随访62个月,全组患者无病生存率为97.0％,总生存率为100％,FOXM1阴性组和FOXM1阳性组的无病生存率差异无统计学意义(97.6％ vs 96.7％,P=0.787).单纯DCIS与DCIS-MI的无病生存率差异无统计学意义(98.7％vs94.7％,P=0.257).FOXM1阳性组,单纯DCIS与DCIS-MI的无病生存率差异无统计学意义(97.6％vs 94.4％,P =0.523);但FOXM1阴性组,单纯DCIS的无病生存率优于DCIS-MI的无病生存率(100.0％vs 85.7％,P=0.028).结论 FOXM1的阳性表达率在DCIS-MI高于单纯DCIS,其可能在DCIS发生浸润过程中起作用.FOXM1阴性表达,可能预测DCIS-MI的预后比单纯DCIS差.

The expression and prognostic value of FOXM1 screened by Array-CGH in ductal carcinoma in situ of breast

Objective To investigate the expression and the predictive prognosis value of FOXM1 screened by Array-CGH (array-comparative genomic hybridization,Array-CGH) in ductal carcinoma in situ of breast.Methods A total of 101 paraffin specimens of breast ductal carcinoma and breast invasive ductal carcinoma were collected from January 2007 lo December 2014.The expression of FOXM1 screened by Array-CGH was detected by immunohistochemistry,and the prognosis of breast ductal carcinoma was evaluated.Results The positive rate of FOXM1 protein in breast ductal carcinoma was 59.4％ (60/101),with no significant correlation with age,menopause,tumor size,axillary lymph node status,HR status,or HER-2 status.FOXM1 expression in pure DCIS was significantly lower than ductal carcinoma in situ with microinvasiveness (12.2％ vs.31.7％,P =0.032).The median follow-up was 62 months.Disease-free survival rate of all was 97.0％.There was no significant difference in disease-free survival between FOXM1 negative group and FOXM1-positive group (97.6％ vs.96.7％,P =0.787).Overall survivals were both 100％ in FOXM1 negative and positive groups.There was no significant difference between pure DCIS and DCIS-MI in DFS (98.7％ vs.94.7％,P =0.257).There was no significant difference in DFS between pure DCIS patients and DCIS-MI patients in FOXM1 positive group (97.6％ vs.94.4％,P =0.523).In FOXM1 negative group,DFS in pure DCIS patients was significantly superior to DCIS-MI patients (100％ vs.85.7％,P =0.028).Conclusion The positive expression of FOXM1 in DCIS-MI is higher than pure DCIS,which may play a role in the infiltration process of DCIS.The negative expression of FOXM1 may predict the poorer prognosis of DCIS-MI than the pure DCIS.