乳腺癌改良根治术患者生物学指标的临床研究

目的：探讨乳腺癌改良根治术患者乳腺癌组织中ＥＲ、ＰＲ、Ｃ-ｅｒｂＢ-２、Ｃｌｕｓｔｅｒｉｎ、ｐ-ｇｐ表达之间的相关性。方法：免疫组化法检测４８例乳腺癌改良根治术患者乳腺癌组织中ＥＲ、ＰＲ、Ｃ-ｅｒｂＢ-２、Ｃｌｕｓｔｅｒｉｎ、ｐ-ｇｐ的表达，应用数据挖掘技术对乳腺癌５种生物学指标进行分析。结果：４８例乳腺癌改良根治术患者乳腺癌组织中，ＥＲ阳性率为４３.８％，ＰＲ３５.４％，Ｃ-ｅｒｂＢ-２６０.４％，Ｃｌｕｓｔｅｒｉｎ６２.５％，ｐ-ｇｐ４１.７％，Ⅱ期ｐ-ｇｐ、Ｃｌｕｓｔｅｒｉｎ表达的阳性率低于ⅢＡ期（Ｐ＜０.０５）。指标聚类分析提示，ＥＲ、ＰＲ和Ｃ-ｅｒｂＢ-２之间具有较强的正相关性，它们与ｐ-ｇｐ、Ｃｌｕｓｔｅｒｉｎ分别呈较弱的负相关性，而ｐ-ｇｐ与Ｃｌｕｓｔｅｒｉｎ之间呈较强的正相关性。二阶段聚类分析结果提示，４８例乳腺癌患者的５个分子标记物情况可分为３类：第１类：Ｃｌｕｓｔｅｒｉｎ（－）、ｐ-ｇｐ（－）、Ｃ-ｅｒｂＢ-２（＋）和ＥＲ（＋）；第２类：Ｃｌｕｓｔｅｒｉｎ（＋）、ｐ-ｇｐ（＋）和Ｃ-ｅｒｂＢ-２（＋）；第３类：Ｃ-ｅｒｂＢ-２（－）、ＥＲ（－）和ＰＲ（－）。结论：Ｃｌｕｓｔｅｒｉｎ和ｐ-ｇｐ在乳腺癌中的表达与ＥＲ、ＰＲ和Ｃ-ｅｒｂＢ-２的表达存在明显的差异且相关性弱，有可能是乳腺癌治疗的新靶点。

A clinical correlation study among the expressions of biological parameters in breast cancer

Objective：To explore the expressions of ER,PR,c-erbB-2,clusterin and p-gp in breast cancer patients with modified radical mastectomy and its clinical correlation.Methods：ER,PR,c-erbB-2,clusterin and p-gp were examined by immunohistochemical staining method in 48 cases of breast cancer,which of data were analyzed by data mining methods.Results：The positive rates of ER,PR,c-erbB-2,clusterin and p-gp were 43.8%,35.4%,60.4%,62.5% and 41.7%,respectively.The expression of clusterin and p-gp in clinical 2 stage for breast cancer were much lower than in clinical 3 stage（P〈0.05）.There were stronger correlations among ER,PR and c-erbB-2,which were weaker negative correlations with clusterin and p-gp with characteristic of stronger correlation.By 2-step clustering analysis,the five biological parameters were divided into 3 classes： clusterin（-）,p-gp（-）,c-erbB-2（＋） and ER（＋）;clusterin（＋）,p-gp（＋） and c-erbB-2（＋）;c-erbB-2（-）,ER（-） and PR（-）.Conclusion：There were conspicuous differences and weaker negative correlations between clusterin,p-gp and ER,PR,c-erbB-2.Clusterin and p-gp may play an important role in targeted therapy of breast cancer.