联合检测乳腺癌组织中CK5／6、Ki一67表达的临床意义

目的检测细胞角蛋白5／6（CK5／6）和Ki-67在乳腺癌组织中的表达情况，并探讨其临床意义。方法应用免疫组织化学方法检测162例乳腺癌患者中CK5／6与Ki．67的表达情况，分析CK5／6与Ki．67表达的相关性以及其与乳腺癌患者的临床病理资料的关系。结果162例乳腺癌患者中三阴性乳腺癌（ER、PR及Her阴性）共12例。CK5／6和Ki．67在162例乳腺癌患者中的表达阳性率分别为30．9％（50／162）及65．4％（106／162），其在三阴性乳腺癌患者中的表达阳性率均明显高于其在非三阴性乳腺癌患者中的表达CK5／6：75．0％（9／12）比27．3％（41／150），X=11．837，P=0．001；Ki-67：100％（12／12）比62．7％（94／150），X=6．847，P=0．009]。CK5／6与Ki．67在乳腺癌中的表达均与患者年龄无关（P〉0．05），均与组织学分级有关（P〈0．05）。CK5／6在乳腺癌组织中的表达与乳腺肿瘤大小和淋巴结转移无关（P〉O．05），而Ki．67在乳腺癌组织中的表达却与其有关P〈0．05）。CK5／6与Ki．67在乳腺癌组织中的表达呈显著正相关（rs=0．271，P=-0．000）。Ki．67在乳腺癌组织中的表达为（＋＋）和（＋＋＋）的病例共64例，其中CK5／6阳性率为43．8％（28／64），明显高于飚．67在乳腺癌组织中表达为（-）和（＋）时的22．4％（22／98），差异有统计学意义（z2=8．233，P=0．004）。CK5／6和Ki．67在乳腺癌组织中的阳性表达均与ER、PR表达呈显著负相关（CK5／6与ER：rs=-0．446，P=0．000；CK5／6与PR：rs=-0．370，P=0．000；Ki-67与ER：rs=-0．518，P=0．000；Ki．67与PR：rs=-0．515，P=0．000），二者均与Her-2的阴性表达无明显相关性（CK5／6与Her-2：rs=-0．105，P=0．183；Ki．67与Her-2：rs=-0．068，P=0．393）。结论CK5／6与Ki．67联合检测可以从来源及发展上评估乳腺癌疾病的基本规律，为乳腺癌术后化疗提供指导。

Clinical Significance of Combined Detection of Expressions of CK5/6 and Ki-67 in Breast Cancer

Objective To detect the expressions of CK5/6 and Ki-67 in breast cancer, and explore the clinical significance. Methods The expressions of CK5/6 and Ki-67 were detected by immunohistochemistry-in 162 cases of breast cancer. The correlation between CK5/6 expression and Ki-67 expression and the relationship of the expressions of two factors to the clinicopathologic factors were analyzed. Results There were 12 cases of the triple negative breast cancer （ negative estrogen receptor （ER）, negative progesterone receptor （PR）, and negative Her-2 ） in 162 patients with breast cancer. The positive rates of CK5/6 and Ki-67 in the breast cancer tissues were 30. 9% （50/162） and 65.4% （106/162）, respectively. The positive rates of CK5/6 and Ki-67 in the patients with triple negative breast cancer were significantly higher than those of non-triple negative breast cancer （CK5/6： 75.0% （9/12） versus 27. 3% （41/150）, X=11. 837, P= 0. 001; Ki-67： 100% （12/12） versus 62.7% （94/150）, X=6. 847, P=0. 009）. The expressions of CK5/6 and Ki-67 in the breast cancer tissues were not associated with age （P〉0. 05）, but they were associated with histology grade （P〈0. 05）.The expression of CK5/6 wasn＇t associated with tumor size and lymph node status （P 〉 0.05）, but the expression of Ki-67 was associated with them （P〈0. 05）. The expression of CK5/6 in the breast cancer tissue had a positive correlation with the expression of Ki-67 in the breast cancer tissue （r~=0. 271, P=0. 000）. There were 64 cases when the expression of Ki-67 was （＋ ~） and （＋ ＋ ＋）, the positive rate of CK5/6 was 43.8% （28/64） and it was significantly higher than that when the expression of Ki-67 was （-） and （＋） （22.4% （22/98）, X=8. 233, P=0. 0041. The positive expressions of CK5/6 and Ki-67 in the breast cancer tissues were negatively correlated with the expressions of ER and PR （CK5/6 and ER： rs=-0. 446, P=0. 000; CK5/6 and PR： rs=-0. 370, P=0. 000; Ki-67 and ER： rs=-0. 518, P=0. 000; Ki-67 and PR： rs=-0. 515, P=0. 000）. The positive expressions of CK5/6 and Ki-67 in the breast cancer tissue were not correlated with the Her-2 expression （CK5/6 and Her-2： rs = 0. 105, P=0. 183; Ki-67 and Her-2 ： rs = 0. 068, P=0. 393）. Conclusion Tbe expressions of CK5/6 and Ki67 not only can evaluate the basic rules of breast cancer from origin and development, but also they are beneficial to choose the chemotherapy of different patients.