乳腺癌组织PTEN和nm23蛋白表达与乳腺癌生物学特性相关性的探讨

目的研究ER、PR、nm23及PTEN基因蛋白在乳腺癌中的表达及临床病理意义。方法采用免疫组织化学S—P法，检测石腊包埋42例乳腺癌组织和12例乳腺小叶增生中PTEN蛋白、nm23蛋白、ER和PR的表达水平。结果PTEN在乳腺癌高表达比乳腺小叶增生低（P〈0．05）。PTEN基因表达与肿瘤大小、临床分期、组织分级和肿瘤复发无相关性，小于45岁患者PTEN表达比大于45岁偏低（P〈0．05）；PTEN高表达与腋淋巴结转移情况有显著负相关性（P〈0．01）；与ER受体呈正相关性。PTEN基因高表达与远处转移有负相关性（P〈0．05）；与5年生存率呈正相关性（P〈0．01）。乳腺恶性肿瘤组织中nm23高表达率与良性组织比较差异无显著性（P〉0．05）。nm23基因表达与肿瘤大小、临床分期、组织分级、肿瘤复发及年龄无相关性，nm23高表达与腋淋巴结转移情况有显著正相关性（P〈0．001），nm23高表达与患者远处转移有显著负相关性（P〈0．001）。与患者5年生存率有正相关性（P〈0．05）。结论nm23与PTEN表达异常与乳腺癌发生发展密切相关，联合检0n．4ER、PR、nm23及PTEN基因的表达可作为一种预测乳腺肿瘤预后和恶性程度的指标。

The association of expressions of PTEN gene and nm23 gene with biological behaviors in breast cancer

Objective To explore the expressions of PTEN gene, nm23 gene, progesterone receptor, and estrogen receptor in breast cancer and their clinical, values. Methods The expression levels of PTEN, nm23, progesterone receptor, and estrogen receptor were detected by immunohistochemistry(S-P method)in 42 samples of paraffin-embedded human breast cancer tissues and 12 samples of hyperplasia of mammary gland tissues. Results The high expression rate of PTEN gene was lower in breast cancer than in hyperplasia of mammary glands(P＜ 0.05). The expression of PTEN gene was not related with tumor size, histological grade, clinical stage and postoperative recurrence; but the high expression rate was higher in elder patients(＞ 45 years)than in young patients(＜ 45 years). The high expression of PTEN was significantly inversely correlated with axillary lymph node metastasis(P＜ 0.01), and had positive relationship with estrogen receptor(P＜ 0.05). The high expression of PTEN was negatively related with distant metastasis(P＜ 0.05), and had positive relationship with 5-year survival rate(P＜ 0.01). The high expression rate of nm23 gene did not differ significantly between breast cancer and hyperplasia of mammary glands(P＞ 0.05). The expression of nm23 gene was not related with tumor size, histological grade, clinical stage, postoperative recurrence, and age. The high expression of nm23 was significantly positively correlated with axillary lymph node metastasis(P＜ 0.01), but was negatively correlated with distant metastasis(P＜ 0.05), and had positive relationship with 5-year survival rate(P ＜ 0.01). Conclusions Abnormal expressions of PTEN gene and nm23 gene are closely associated with the tumorigenesis and development of primary breast cancer. Combined detection of expressions of PTEN, nm23, progesterone receptor and estrogen receptor can be used as a predictor for biological behaviors and prognosis of breast cancer.