芳香化酶在乳腺癌中表达的临床病理学观察

目的研究芳香化酶对乳腺癌增殖和侵袭性的影响,探求乳腺癌局部产生的雌激素与乳腺癌生物学特性的关系。方法应用免疫组织化学方法检测腋淋巴结无转移的原发性乳腺癌组织内芳香化酶的表达,分析其与金属蛋白酶2（matrix metalloproteinases 2,MMP2）、金属蛋白酶9（matrix metalloproteinases 9,MMP9）及肿瘤的大小、分级和雌激素及孕激素受体等的相关性。结果在原发性乳腺癌细胞中芳香化酶的表达弱阳性（＋）者占25．0％、阳性（＋＋）者占29．9％;芳香化酶状态与MMP2、MMP9以及二者的共表达成正相关（P〈0．05）,但与肿瘤的大小、ER与PR表达、月经状态、组织学类型及病理分级无相关性（P〉0．05）;在绝经后患者中芳香化酶的表达与肿瘤的大小成正相关（P〈0．05）,而在绝经前的患者中二者无相关性（P〉0．05）;在ER和（或）PR阳性的肿瘤中芳香化酶的表达与MMP2／MMP9的共表达成正相关（P〈0．05）,而在ER和PR均阴性的肿瘤中二者无相关性（P〉0．05）。结论乳腺癌组织内表达的芳香化酶所产生的局部雌激素环境在部分乳腺癌中可能通过ER通路刺激肿瘤的增殖及增强肿瘤的侵袭性,这一现象在绝经后的患者体内表现更为明显。

Clinicopathological significance of aromatase expression in breast cancers

Objective To study the effects of aromatase on breast cancer proliferation and invasive ability,so as to detect the relationship between in situ estrogen levels and molecular biological characteristics of breast cancer.Methods By immuhistochemistry staining,the expression of aromatase,matrix metalloproteinases 2(MMP2)and matrix metalloproteinases(MMP 9)in the primary breast cancers were detected,the associations between aromatase and MMPs as well as clinical-pathological factors were analyzed.Results The positive rates of aromatase were 25.0%(+)and 29.9%(+ +).Aromatase status was associated with MMP2,MMP9 and co-expression of MMP2 and MMP9(P<0.05),but not associated with tumor size,ER/PR status,menopausal status and tumor grade(P>0.05).In the postmenopansal patients there was a relationship between aromatase and tumor size(P<0.05),but not in the premenopausal patients(P>0.05);there was a relationship between aromatase and co-expression of MMP2/MMP9 in the patients with ER and/or PR positive(P<0.05),but not in the patients with ER and PR negative(P>0.05).Conclusions In the breast cancer in situ estrogen produced by tumor aromatase may promote the cancer cells proliferation and invasiveness and maybe through ER pathway especially in the postmenopausal patients.