乳腺癌CD44v6和Survivin的表达与临床预后的相关性研究

研究CD44v6和Survivin的表达与乳腺癌临床病理特征和生存率的关系以及在乳腺癌和良性乳腺疾病的表达差异。方法:用免疫组化法检测64例乳腺癌标本和12例良性乳腺（对照组）标本CD44v6和Survivin表达。将乳腺癌病例按表达分成A组（双阳性组）、B组（单阳性组）和C组（双阴性组），随访生存情况。结果:乳腺癌组和对照组中CD44v6阳性率分别为57.81%和25.00%（P=0.037），Survivin阳性率分别为73.43%和8.33%（P<0.001）。乳腺癌组织中CD44v6和Survivin表达均高于对照组。CD44v6和Survivin的表达与年龄、肿瘤大小、组织学分级和分类均无明显相关（P>0.05），但与临床分期和淋巴结转移明显相关（P<0.05）。A、B、C组的平均生存期分别为（84.07±6.69）、（103.89±6.77）、（115.50±7.42）个月。64例乳腺癌患者的平均生存期为（97.43±4.59）个月。A、B、C组的5年总生存率分别为74.19%、90.91%、100.00%；10年总生存率分别为35.48%、59.09%和72.73%（P=0.043）。结论:CD44v6和Survivin表达分布存在组织特异性。两者过量表达与年龄、肿瘤大小、组织学分级及组织学分类之间均无统计学差异，但与临床分期和淋巴结转移存在显著性差异。两者均阳性表达患者5年和10年生存率最低。CD44v6和Survivin均是乳腺癌的预后因素，有助于指导治疗和预测预后。 

Significance and Correlation of CD44v6 and Survivin Tissue Expressions in Breast Cancer

To investigate the relationship between CD44v6 and survivin expressions, and determine the biological behavior of breast cancer, and explore the clinical significance of the two tumor marker proteins in breast cancer patients. Methods: CD44v6 and survivin expressions were examined in the tissues of 64 breast cancer patients ( breast cancer group ) and 12 patients with benign breast diseases ( control group ) via immunohistochemistry. The breast cancer group was divided into three subgroups based on CD44v6 and survivin tissue expressions: Arm A ( two markers positively expressed ), Arm B ( one marker positively expressed ), and Arm C ( neither of the markers positively expressed ). Results: The positive expression rates of CD44v6 and survivin were 57.81% and 25.00% ( P = 0.037 ) in the breast group and 73.43% and 8.33% ( P = 0.000 ) in the control group, respectively. The differences in the expression between the two groups were statistically significant. The overexpressions were correlated with the clinical stage and lymph node metastasis ( P < 0.05 ), but not with patient age, tumor diameter, histology classification, and grade ( P > 0.05 ). The mean survival time ( MST ) of Arm A, Arm B, and Arm C were (84.07 ± 6.69), (103.89 ± 6.77), and (115.50 ± 7.42) months, respectively. Their 5- and 10-year overall survival rates were 74.19%, 90.91%, and 10.00%; and 35.48%, 59.09%, and 72.73%, respectively (χ2 = 6.316, P = 0.043 ). The differences were statistically significant. Conclusion: The specific overexpressions of CD44v6 and survivin occur in breast cancer and normal breast tissues. The overexpressions were correlated with the clinical stage and lymph node metastasis, but not with age, tumor diameter, histology classification, and grade. Patients who exhibited CD44v6 and survivin overexpressions had a higher lymph node metastatic rate and low survival time. Detecting both CD44v6 and survivin expressions is a reliable method of evaluating the treatment and diagnosis of breast carcinoma.