TopoⅡα在乳腺癌中的表达及其临床意义

摘要

背景与目的:DNA拓扑异构酶Ⅱ α(topoisomerase Ⅱ α,Topo Ⅱ α)是一个与恶性肿瘤增殖相关的基凶,目前其对乳腺癌发生发展的影响已成为研究热点.本研究探讨TopoⅡ α在乳腺良恶性疾病中的表达特点及其与乳腺癌临床病理特征的关系及其临床意义.方法:用免疫组化SP法检测797例乳腺浸润性导管癌、32例导管内癌、25例导管上皮不典型增生和40例乳腺病中TopoⅡ α蛋白的表达水平.结果:TopoⅡ α在乳腺病组织、导管上皮不典型增生组织、导管内癌组织及浸润性导管癌组织中的阳性率分别为25%、28%、53.1%和53.6%,在乳腺上皮增生发展为癌的过程中,Topo Ⅱ α表达水平逐渐增高(P＜0.05);TopoⅡ α在有淋巴结转移组表达阳性率为74.4%,显著高于无淋巴结转移组44.8%(P＜0.01);CerbB-2阳性的乳腺癌TopoⅡ α的阳性率为73.1%,CerbB-2阴性的乳腺癌Topo Ⅱ α的阳性率为37.8%,两者相比,差异有统计学意义(P＜0.01).Topo Ⅱ α表达与年龄、肿瘤的大小、组织学分级、临床分期、ER及PR无相关性(P＞0.05).结论:Topo Ⅱ α表达增高对乳腺痛的发生和发展具有一定作用,Topo Ⅱ α表达可能与乳腺痛的淋巴结转移有关,与CerbB-2高表达相关,可为乳腺癌的治疗效果提供必要的理论依据.%Background and purpose: DNA Topoisomerase Ⅱα (Topo Ⅱα) is a gene involved in the proliferation of malignant tumors.Its influence in the development and progression of breast cancer caused increasing interest in its research.This study investigated the expression of Topo Ⅱα in benign and malignant breast diseases and its clinical significance in breast carcinoma.Methods: The expression of Topo Ⅱα was detected using immunohistochemistry in 97 infiltrating ductal carcinoma tissues, 32 intraductal carcinoma tissues, 25 atypical hyperplasia of ductal epithelium tissues and 40 mastopathia tissues.Results: The positive expression of Topo Ⅱα was found in 53.6％ of infiltrating ductal carcinoma tissues, 53.1％ of intraductal carcinoma tissues, 28％ of atypical hyperplasia of ductal epithelium tissues, and 25％ of mastopathia tissues.Statistically significant differences and positive correlations in Topo Ⅱα expression among the stages of disease progression from normal to invasive carcinoma were observed (P＜0.05).The positive expression rate of Topo Ⅱα in breast carcinoma tissues with lymph node metastases was significantly higher than that with no lymph node metastases (P＜0.01).Statistically significant differences in the presence of Topo Ⅱα (+)/CerbB-2 (+) 73.1％ and Topo Ⅱα (+)/CerbB-2 (-) 37.8％ patterns were noted in the invasive carcinoma (P＜0.01).No statistically significant differences in invasive carcinoma were found between Topo Ⅱα and age, tumor size, histological class, clinical stage, ER or PR (P＞0.05).Conclusion: These results suggest that the increased expression of Topo Ⅱα may play an important role in the development and progression of the breast carcinoma.There may be an association between the expression of Topo Ⅱα and lymph node metastases as well as the high expression of CerbB-2.