性激素三项(E2、FSH、LH)与乳腺癌分子亚型及复发风险的相关性研究

摘要

Objective To research the relationship and meaning between sex hormones (as E2,FSH and LH) and clinical pathological features (as ER,PR,HER-2 and Ki-67),molecular typing,the recurrence risk of breast cancer,and to find the clinical significance in breast cancer diagnosis and prognosis by 3 sex hormones detection.Methods 86 female patients with breast cancer admitted from November 2011 to May 2013 in our hospital were enrolled in the research,including 31 postmenopausal cases (regarded as postmenopausal group) and 55 premenopausal cases (as premenopausal group).The 3 items of sex hormone (E2,FSH,LH) were detected by acridinium ester chemiluminescence method,the expression of ER,PR,HER-2 and Ki-67 were measured by SP immunohistochemical technique,and their relationships with clinicopathological features and recurrence risk assessment were analyzed by two independent samples t-test,Spearman rank correlation and rank-sum test.Results There was no obvious correlation between the level of three hormones(E2、FSH、LH) and expression of ER and PR by two independent samples t-test,Spearman rank correlation and ranksum test (P ＞ 0.05).There was direct correlation between FSH level and HER-2 expression in all 86 patients (t =2.167,P =0.034).In postmenopausal group,FSH level was not relevant with HER-2 status (t =1.751,P =0.102),but higher than the value of E2 and LH.While in premenopausal group,FSH level was relevant with HER-2 status (t =2.172,P =0.036).LH levels and Ki-67 expression levels were correlated positively (the correlation coefficient =0.546,P =0.043),and both FSH and LH levels were significant positive correlated to molecular typing (the correlation coefficient =0.644 or 0.632 respectively,P =0.013 or 0.015 respectively) in postmenopausal group.FSH level is significant related to recurrence risk of breast cancer in postmenopausal group(x2 =7.610,P =0.022) and in premenopausal patients(x2 =6.030,P =0.049).Conclusions Status and level of expression of ER and PR has nothing to do with the 3 sex hormones (E2,FSH and LH) with relatively constant.FSH level in premenopausal breast cancer patients with HER-2 expression is positively correlated.The LH level and Ki-67 expression is positively correlated in postmenopausal breast cancer patients.The FSH,LH level and molecular typing is significant correlation in post-menopausal breast cancer patients.Whether menopause or not,FSH level is significantly related to the risk of recurrence in breast cancer patients.%目的 探讨乳腺癌患者性激素三项(E2、FSH、LH)与ER、PR、HER-2、Ki-67临床病理特征以及分子分型、复发风险的关系. 方法 对2011年11月～2013年5月在我院收治的86例乳腺癌患者,其中绝经患者(绝经组)31例,未绝经患者(未绝经组)55例,采用吖啶酯化学发光法检测性激素三项(E2、FSH、LH),采用SP免疫组化法检测ER、PR、HER-2及Ki-67的表达.通过两独立样本t检验、Spearman秩相关、秩和检验等方法研究性激素三项与ER、PR、HER-2及Ki-67临床病理特征及复发风险的关系. 结果 经两独立样本t检验和Spearman秩相关分析,患者性激素三项与ER、PR表达水平无相关性(P均＞0.05).患者整体FSH水平与HER-2状态正相关(t=2.167,P =0.034),绝经组FSH水平与HER-2状态无明显相关(t=1.751,P=0.102),但较E2和LH的t值大,而未绝经组FSH水平与HER-2状态正相关(t=2.172,P=0.036).在绝经组LH的水平与Ki-67的表达水平呈正相关(相关系数=0.546,P=0.043).绝经组FSH及LH的水平与分子分型呈显著性正相关(相关系数分别为0.644和0.632,P分别为0.013和0.015,均＜0.05).绝经组患者FSH与复发风险存在统计学意义(x2 =7.610,P=0.022,P＜0.05);未绝经组患者FSH与复发风险存在统计学意义(x2 =6.030,P=0.049,P＜0.05). 结论 ER、PR的表达状态及表达水平与E2、FSH及LH这三项性激素无关,相对恒定;在未绝经的乳腺癌患者中,FSH水平与HER-2的表达呈正相关;在已绝经的乳腺癌患者中,LH水平和Ki-67的表达呈正相关,FSH、LH水平与分子分型明显相关;无论绝经与否,乳腺癌患者FSH水平与其复发风险明显相关.