p53,Ki-67及E-钙黏蛋白在三阴性乳腺癌中的表达及预后

摘要

目的:探讨p53,Ki-67及E-钙黏蛋白(E-cadherin)在三阴性乳腺癌(triple negative breast cancer,TNBC)组织中的表达及预后的关系.方法:采用免疫组织化学法检测52例TNBC和52例非三阴性乳腺癌(non-triple-negative breast cancer,NTNBC)组织中p53,Ki-67及E-cadherin表达情况,观察3个指标与TNBC患者临床病理学特征及预后的关系.结果:TNBC组织中p53,Ki-67及E-cadherin的阳性表达率分别为67.3％,80.8％,26.9％;而在NTNBC组织中为44.2％,61.5％,48.1％(均P＜0.05).在TNBC组织中,p53表达阳性与肿瘤大小、TNM分期及组织学分级有关(均P＜0.05);Ki-67表达阳性与TNM分期、淋巴结转移有关(均P＜0.05);E-cadherin表达阳性与肿瘤大小、TNM分期、淋巴结转移有关(均P＜0.05).在TNBC患者中,p53,Ki-67及E-cadherin表达阳性者与阴性者总体生存率(overall survival,OS)的差异均有统计学意义(P＜0.05).Cox回归分析多因素显示:淋巴结转移、p53、Ki-67及E-cadherin表达是影响TNBC患者总体生存率的独立预后因素(均P＜0.05).结论:TNBC组织中,p53、Ki-67高表达,其表达阳性者预后差,E-cadherin低表达,其表达阳性者预后良好.联合检测p53、Ki-67及E-cadherin表达可为TNBC患者的治疗提供新靶点.%Objective:To investigate the expression of p53,Ki-67,E-cadherin and their prognostic value in triple negative breast cancer (TNBC).Methods:The expression of p53,Ki-67,E-cadherin was assessed by immunohistochemistry in 52 cases of TNBC and 52 cases of non-triple negative breast cancer (NTNBC).The association of the clinicopathological variables and the prognostic value of p53,Ki-67 and E-cadherin expression were evaluated in TNBC.Results:The positive expression rates ofp53,Ki-67,E-cadherin in TNBC were 67.3％,80.8％,26.9％,while the positive expression rates of those in NTNBC were 44.2％,61.5％,48.1％ (all P＜0.05).In TNBC,p53 expression was associated with tumor size,TNM stage and histological grade (all P＜0.05),Ki-67 expression was associated with TNM stage and lymph node metastasis (both P＜0.05),and E-cadherin expression was correlated with tumor size,TNM stage,and lymph node metastasis (all P＜0.05).In TNBC,there was significant difference in overall survival (OS) of the positive and negative p53,Ki-67 and E-cadherin patients (all P＜0.05).Cox regression was used for analysis of factors for TNBC patients.Expression of lymph node metastasis,p53,Ki-67,E-cadherin are independent prognostic factor affecting overall survival of TNBC according to Cox regression analysis of multiple factors (all P＜0.05).Conclusion:In TNBC,the high expression of p53,Ki-67 has poor prognosis,while the low expression of E-cadherin has good prognosis.Therefore,our data suggests that the combined examination of p53,Ki-67 and E-cadherin expression might be useful prognostic markers in TNBC and might provide molecular targeting therapy of TNBC treatment.