浸润性乳腺癌ER、PR、HER-2、E-cadherin、CK5/6检测与临床预后关系

摘要

Purpose To investigate the expression of ER, PR, HER-2 , E-cadherin, CK5/6 in invasive breast cancer and to study the relationship between their expression with prognosis. Methods Application of ER, PR, HER-2, E-cadherin, CK5/6 antibody in 64 cases of invasive breast cancer patients were performed by immunohistochemistry analysis, results were statistically analyzed. Results The posivite rates of ER, PR, HER-2, E-cadherin, CK5/6 expression in 64 cases of invasive breast cancer were 60. 93％ , 56. 25％ , 37. 50％ , 89. 06％ , and 10. 94％ respectively. The statistical analysis showed ER and PR was positive correlation ( r = 0. 646, P =0. 000 ). ER and HER-2, CK5/6 expression was negative correlation ( r = - 0. 320,P = 0. 010; r = - 0. 385 ,P = 0. 002 ). PR and HER-2 , CK5/6 expression was a negative correlation ( r = - 0. 392 . P = 0. 013 ; r = - 0. 362 . P = 0. 003 ). Using x2 test or Fisher exact probability analysis, ER, CK5/6 expression were related to the histological grading( P ＜ 0. 05 ). However, PR, HER-2, and Ecadherin expression were unrelated to the age, menopause status, tumor size, histological grade, lymph node metastasis and tumor stage ( P ＞0. 05 ). There was no significant difference between ER, CK5/6 expression and the age, menopause status, tumor size,lymph node metastasis and tumor stage( P ＞ 0. 05 ). Log-rank survival curves showed the overall survival ( OS ) in HER-2 or CK5/6 positive patients was lower than that in HER-2 or CK5/6 negative patients ( OS: P = 0. 048 and P = 0. 041 ). The OS in E-cadherin positive patients was higher than that E-cadherin negative patients( OS : P = 0. 038 ). But the correlation hetween ER, PR expression with overall survival was no significant difference ( OS : P ＞ 0. 05 ). OS in the patients with higher histological grade was lower ( OS : P = 0. 048 ). The age, menopause status, tumor size, lymph node metastasis, clinical stage and overall survival ( OS ) had no significant correlation ( Os : P ＞ 0. 05 ). Conclusion ER, PR, E-cadherin expression loss, HER-2 or CK5/6 positive expression, higher histological grade suggest poor prognosis of invasive breast cancer. The combined detection of ER, PR,HER-2, E-cadherin, CK5/6 expression can provide a strong biomarker for the clinical outcomes in IBC.%目的 探讨ER、PR、HER-2、E-cadherin、CK5/6检测与浸润性乳腺癌(invasive breast cancer,IBC)临床预后关系.方法 应用ER、PR、HER-2、E-cadherin、CK5/6抗体,对64例IBC患者进行免疫组化检测,检测结果后行统计学分析.结果 64例IBC中ER、PR、HER-2、E-cadherin、CK5/6阳性表达率分别为60.93%、56.25%、37.50%、89.06%、10.94%.经统计学分析,ER与PR表达呈正相关(r=0.646,P=0.000);ER与HER-2、CK5/6表达呈负相关(r=-0.320,P=0.010;r=-0.385,P=0.002);PR与HER-2、CK5/6表达呈负相关(r=-0.392,P= 0.013;r=-0.362,P=0.003).采用χ2检验或Fisher精确概率法分析,ER、CK5/6在组织学分级中有统计学意义(P<0.05).患者在不同年龄、是否绝经、肿瘤大小、组织学分级、有无淋巴结转移及肿瘤分期之间,PR、HER-2和E-cadherin均无统计学意义(P>0.05).ER、CK5/6在患者的不同年龄、是否绝经、肿瘤大小、有无淋巴结转移及肿瘤分期之间的差异均无统计学意义(P>0.05).采用Kaplan-Meier法,生存曲线间的比较采用Log-rank检验,总生存率(OS):HER-2或CK5/6阳性患者较阴性患者低(OS:P=0.048和P=0.041).E-cadherin阳性患者较阴性患者总生存率(OS)高(OS:P=0.038).但ER、PR的表达与总生存率相关性无统计学意义(OS:P>0.05).患者的组织学分级越高,总生存率(OS)越低(OS:P=0.048).患者在不同年龄、是否绝经、肿瘤大小、有无淋巴结转移、临床分期与总生存率(OS)相关性无统计学意义(OS:P>0.05).结论 IBC中ER、PR、E-cadherin表达丧失,HER-2或CK5/6呈阳性表达,组织学分级呈高级别,提示IBC患者预后较差.联合检测IBC组织中ER、PR、HER-2、E-cadherin、CK5/6的表达,可为IBC临床预后评估提供有力依据.