CXCR4和CXCL12及PTEN在乳腺癌中的表达及临床意义

 目的  分析乳腺癌、乳腺纤维腺瘤及癌旁正常乳腺组织中趋化因子受体4（CXCR4）、趋化因子12（CXCL12）与人第10号染色体缺失的磷酸酶及张力蛋白同源的基因（PTEN）的表达及临床意义。方法  采用免疫组化技术SABC法检测60例乳腺癌组织标本CXCR4、CXCL12、PTEN的表达情况，分析乳腺癌中CXCR4、CXCL12及PTEN表达与年龄、肿瘤大小、组织学分级、TNM分期、淋巴结转移、雌激素受体（ER）、人类表皮生长因子2（Her-2）及脉管侵犯的关系。另取20例乳腺纤维腺瘤及20例癌旁正常乳腺组织作为对照组。结果  免疫组化结果显示，CXCR4（χ²=48.750，P=0.000）、CXCL12（χ²=47.611，P=0.000）及PTEN（χ²=19.994，P=0.000）在乳腺癌、乳腺纤维腺瘤与癌旁正常组织中的表达差异均具有统计学意义，其中CXCR4、CXCL12阳性表达与乳腺癌的组织学分级（χ²=11.080，P=0.004；χ²=6.978，P=0.031）、TNM分期（χ²=9.819，P=0.007；χ²=10.163，P=0.006）、淋巴结转移（χ²=6.213，P=0.013；χ²=8.031，P=0.005）、ER（χ²=12.774，P=0.000；χ²=7.330，P=0.007）、脉管侵犯（χ²=5.860，P=0.013；χ²=5.185，P=0.020）及Her-2（χ²=5.487，P=0.019；χ²=4.689，P=0.030）相关；PTEN在乳腺癌组织中的表达与TNM分期（χ²=7.366，P=0.025）、淋巴结转移（χ²=5.511，P=0.019）及ER（χ²=4.077，P=0.043）状态相关。CXCR4与CXCL12在乳腺癌中的表达呈正相关（r =0.336，P=0.004）；CXCR4与PTEN、CXCL12与PTEN在乳腺癌中的表达呈负相关（r =-0.362，P=0.004；r =-0.360，P=0.004）。结论  趋化因子CXCL12及其受体CXCR4的高表达及PTEN的低表达与乳腺癌的发生和转移有关，可能在促进乳腺癌的生长和发展中起重要作用。

Expression and clinical significance of CXCR4, CXCL12 and PTEN in breast cancer

Objective  To analyse the expression and clinical significance of CXCR4, CXCL12 and PTEN in breast cancer, fibroadenoma of the breast cancer and adjacent normal breast tissue. Methods  The expressions of CXCR4, CXCL12 and PTEN in 60 cases of breast cancer were detected by immunohistochemistry technique SABC method. The correlations of levels of CXCR4, CXCL12 and PTEN expression and the age of patient, tumor diameter, histological grade, TNM stage, lymph node metastasis, ER status, Her-2 status, and vessel invasion were analysed. Twenty cases of breast fibroadenoma tissues and 20 cases of normal breast tissues were analysed as controls. Results  The expression of CXCR4 (χ²=48.750, P=0.000), CXCL12 (χ²=47.611, P=0.000) and PTEN (χ²=19.994, P=0.000) in breast cancer, normal breast tissues and breast fobroadenoma showed significant difference. The positive expression of CXCR and CXCL12 were significantly correlated with histological grade (χ²=11.080, P=0.004；χ²=6.978, P=0.031), TNM stage (χ²=9.819, P=0.007；χ²=10.163, P=0.006), lymph node metastasis (χ²=6.213, P=0.013；χ²=8.031, P=0.005), ER (χ²=12.774, P=0.000；χ²=7.330, P=0.007), vessel invasion (χ²=5.860, P=0.013; χ²=5.185, P=0.020) and Her-2 (χ²=5.487, P=0.019；χ²=4.689, P=0.030). The expression of PTEN in breast cancer was significantly correlated with TNM stage (χ²=7.366, P=0.025), lymph node metastasis (χ²=5.511, P=0.019) and ER state (χ²=4.077, P=0.043). There was a positive correlation between the expression of CXCR4 and the expression of CXCL12 in breast cancer (r =0.336, P=0.004). There was a negative correlation between the expression of CXCR4 and the expression of PTEN in breast cancer (r =-0.362, P=0.004). There was a negative correlation between the expression of CXCL12 and the expression of PTEN in breast cancer (r =-0.360, P=0.004). Conclusion  The high expression of the chemokine CXCL12 and its receptor CXCR4 and the low expression of PTEN are closely related to the carcinogenesis and metastasis of breast cancer, which may play an important role in the development of breast cancer.