乳腺癌c-erbB-2与雌孕激素受体及淋巴结转移的相关性分析

目的：分析乳腺癌c-erbB-2的表达与ER、PR，以及腋窝淋巴结、肿瘤大小、病理类型的相关性。方法：收集术前未行新辅助化疗而行手术切除加腋窝清扫的乳腺癌病人346例，采用免疫组化法检测c-erbB-2、ER及PR；比较c-erbB-2表达与ER、PR、腋窝淋巴结、肿瘤大小以及病理类型之间的关系。结果：c-erbB-2阳性表达者占48．2％，腋窝淋巴结有转移者的c-erbB-2阳性表达为69．6％，而淋巴结阴性者则为34．6％（P〈0．001）。ER、PR均阳性且c-erbB-2表达也阳性者为38．1％；而ER、PR均阴性、c-erbB-2阳性者达64．6％（P〈0．001）。仅ER阳性和阴性者的c-erbB-2阳性表达分别是40．7％和69.2％（P（0．001）。仅PR阳性和阴性者的c-erbB-2阳性分别为46．4％和49．7％（P〉0．05）。〈2cm和2～5cm肿瘤的c-erbB-2阳性率分别是47．1％和48．8％（P〉0．05）。导管内癌和黏液癌的c-erbB-2表达阳性率分别达73．8％和60．0％。结论：c-erbB-2阳性表达与腋窝淋巴结的转移呈正相关，与ER呈负相关，与PR和肿瘤大小不相关。c-erbB-2是判断乳腺癌预后的良好指标。

Expression of c-erbB-2, and its inter-relationship with ER and PR protein in the primary breast lesions and metastatic axillary lymph nodes

Objective To observe the protein expression of c-erbB-2 and its interrelationships with ER,PR,axillary lymph node metastasis,tumor size and pathological type.Methods Immunohistochemical staining for c-erbB-2,PR and ER was performed on paraffin embedded tumor specimens obtained from 346 cases of breast cancer without undergoing neo-adjuvent therapy,and correlation was also studied with tumor size,nodal status and pathological type.Results The total positive rate of c-erbB-2 in 346 cases was 48.2%.The expression of c-erbB-2 was 69.6% in patients with axillary lymph node metastasis and 34.6% in those without axillary lymph node metastasis(P<0.001).The positive rate of c-erbB-2 was 38.1% in both ER-positive and PR-positive patients,64.6% in both ER-negative and PR-negative patients(P<0.001);it was 40.7% in ER-positive patients and 69.2% in ER-negative patients(P<0.001);46.4% in PR-positive and 49.7% in PR-negative patients(P>0.05).The positive rate of c-erbB-2 was 47.1% and 48.8% in breast cancer of diameters<2 cm and 2-5 cm respectively.The positive rate of c-erbB-2 expression in tissues of intraductal breast cancer was 73.8%,and in mucinous carcinoma(60%),it was significantly higher than in other pathological types.Conclusions c-erbB-2 positive has important significance in patients with axilla lymphatic metastasis.The expression of c-erbB-2 was negatively corrlated with the expression of ER and bore no relation to PR.c-erbB-2 can be used as a independent indicator for the prognosis of patients with breast cancer.