E-cadherin在不同分子分型乳腺癌中的表达及其在三阴性乳腺癌中的临床意义

目的:探讨不同分子分型乳腺癌中E－钙黏素蛋白（E-cadherin）的表达及其在三阴性组中的临床意义。方法:收集2012年1月至2013年12月乳腺浸润性导管癌共188例，应用免疫组织化学及荧光原位杂交技术将乳腺癌分为Luminal A型49例、Luminal B型41例、HER-2阳性型44例，三阴性组（TNBC）54例。免疫组织化学检测的E-cadherin的表达情况同时分析E-cadherin在TNBC中与临床病理特征关系，并随访54例TNBC患者3年复发或转移率及PFS。结果:乳腺癌中E-cadherin阳性率为52.13%，Luminal A型组阳性率为63.27%、Luminal B型组阳性率为63.41%、HER-2阳性组阳性率为43.18%及TNBC组为42.59%，四组间阳性率差别具有统计学意义(χ2=7.89,P<0.05)。TNBC与HER-2阳性组间差别无统计学意(χ2=0.003,P>0.05)，而TNBC组阳性率较Luminal A型组和Luminal B 型组均明显降低，差别具有统计学意义(42.59% vs 63.27%，χ2=4.40，P<0.05，42.59% vs 63.41%，χ2=4.05，P<0.05)；TNBC中E-cadherin阳性表达与年龄无关 (P>0.05)，与肿瘤大小、TNM分期、组织学分级、淋巴结转移状态及Ki67负相关，差别具有统计学意义(P<0.05)；TNBC总体3年复发或转移率高达55.56%，无病生存率为44.44%。E-cadherin阳性组复发转移率为39.13%，E-cadherin阴性组复发转移率为67.74%，差别有统计学意义（χ2=4.38，P<0.05），3年无疾病进展时间（PFS）E-cadherin阳性组明显优于阴性组（P<0.05）。结论:不同分子分型乳腺癌中E-cadherin表达不同，E-cadherin阳性表达与肿瘤大小、组织学分级、分期及浸润转移呈负相关，对预测3年复发转移有一定意义。

The expression of E-cadherin in different molecular type of breast cancer and its clinical significance in TNBC

Objective:To investigate the expression of E-cadherin in breast cancer in different molecular type of breast cancer and its clinical significance in triple negative breast cancer (TNBC).Methods:188 cases with breast invasive ductal carcinoma in our hospital from January 2012 to December 2013 were collected.According to immunohistochemistry technology and fluorescence in Situ Hybridization，we categorized those cases into Luminal A group(49 cases)，Luminal B group(41 cases)，HER-2 positive group(44 cases)，and triple negative group (TNBC) (54 cases).The expression of E-cadherin detected by Immunohistochemistry in breast cancer with different molecular subtyping was determined.The relationship between E-cadherin and clinicopathologic characteristics was analyzed in TNBC.And the recurrence or metastasis rate of 54 cases with TNBC was followed up for 3 years.Results:The positive rate of E-cadherin in breast cancer was 52.13%.The positive rate of Luminal A group was 63.27%，Luminal B group was 63.41%，HER-2 positive group was 43.18%，and that of TNBC group was 42.59%.The difference of positive rate between four groups was statistically significant (χ2=7.89,P<0.05).The difference between TNBC and HER-2 positive group was not statistically significant (χ2=0.003,P>0.05)，while the positive rate of TNBC group was significantly lower than that of Luminal A group and Luminal B group，and the difference was statistically significant (42.59% vs 63.27%，χ2=4.40,P<0.05 and 42.59% vs 63.41%，χ2=4.05,P<0.05).The positive expression of E-cadherin in TNBC was not related to age (P>0.05)，and negatively correlated with tumour size，TNM stage，histological grade，lymph node status and vascular invasion.The difference was statistically significant (P<0.05).The overall recurrence rate and metastasis rate of TNBC was 55.56% in 3 years，and the disease-free survival rate was 44.44%.The metastasis rate of E-cadherin positive group recurrence was 39.13%，the metastasis and recurrence rate of E-cadherin negative group was 67.74%，the difference was statistically significant (χ2=4.38，P<0.05)，E-cadherin negative expression is prone to recurrence and metastasis.The PFS of E-cadherin positive group is better than that of E-cadherin negative group Conclusion:The expression of E-cadherin in different molecular subtypes of breast cancer is different，and the positive expression of E-cadherin is negatively correlated with tumour size，histological grade，stage and invasion and metastasis.It has certain significance in predicting recurrence and metastasis in 3 years.