腋淋巴阴性乳腺癌分子标记与预后相关性研究

为探讨ｃ－ｅｒｂＢ－２、ｐ５３、雌激素受体（ＥＲ）、孕激素受体（ＰＲ）和ＤＮＡ合成时相细胞百分率（ＳＰＦ）对腋淋巴阴性乳腺癌（ＡＮＮ）患者的预后提示价值,作者选择１８０例ＡＮＮ患者,以９项可能影响预后的临床病理指标作为病例配对条件,按１：２配对得到２７对（８１例）ＡＮＮ乳腺癌患者,分别测定其肿瘤ｃ－ｅｒｂＢ－２、ｐ５３、ＥＲ、ＰＲ蛋白表达和ＳＰＦ,结合随访结果进行ｌｏｇｒａｎｋ检验及ＣＯＸ回归数学模型进行危险度分析。结果显示,在５项生物特性指标中,ＳＰＦ对ＡＮＮ乳腺癌患者预后的提示作用最强。ＡＮＮ患者的５年无瘤生存率,ＳＰＦ＜１０％者为９２％,＞１０％者为５２％（Ｐ＜０．００１）。ＳＰＦ单独指标的复发危险度可达１１．３１。其余４项指标的复发危险度按次序分别为ＰＲ、ＥＲ、ｐ５３、ｃ－ｅｒｂＢ－２。作者认为多指标综合分析,ＰＲ和ＥＲ分别与ＳＰＦ联合应用,可进一步了解复发危险度。

Prognosis prediction of S-phase fraction and p53, c-erbB-2, estrogen receptor, progesterone receptor in axillary node-negative breast cancer

The prognostic factors in 180 axillary node negative breast cancer patients with more than 5 year follow up were searched for with multiple regression. Based on the regression results, the cases with treatment failure in 5 year and the cases with 5 year disease free survival were matched at 1:2 ratio.Then the c erbB 2 protein, p53 Protein, estrogen receptor (ER), progesterone receptor (PR)and the S phase fraction (SPF) were measured in paraffin embedded breast cancer tissue. The results were analysed with log rank test and Cox Model.Among the biobehaviour factors measured,the SPF was the strongest prognosis predictor for ANN. The 5 year disease free survival rate of ANN with SPF<10% or>10% was 94% and 52% respectively ( P <0 001). The treatment failure relative risk of patients with SPF>10% ANN was 11 31. The relative risk of other four factors was respectively,PR 3 58 ( P <0 002), ER 2 93 ( P <0 05), p53 1 44 ( P >0 3), c erbB 2 1 38 ( P >0 5). The combination of PR or EP with SPF could make the relative risk even higher.