E-cadherin在不同分子分型乳腺癌中的表达及其在三阴性乳腺癌中的临床意义

摘要

目的:探讨不同分子分型乳腺癌中E-钙黏素蛋白(E-cadherin)的表达及其在三阴性组中的临床意义.方法:收集2012年1月至2013年12月乳腺浸润性导管癌共188例,应用免疫组织化学及荧光原位杂交技术将乳腺癌分为Luminal A型49例、Luminal B型41例、HER-2阳性型44例,三阴性组(TNBC)54例.免疫组织化学检测的E-cadherin的表达情况同时分析E-cadherin在TNBC中与临床病理特征关系,并随访54例TNBC患者3年复发或转移率及PFS.结果:乳腺癌中E-cadherin阳性率为52.13%,Luminal A型组阳性率为63.27%、Luminal B型组阳性率为63.41%、HER-2阳性组阳性率为43.18%及TNBC组为42.59%,四组间阳性率差别具有统计学意义(χ2=7.89,P<0.05).TNBC与HER-2阳性组间差别无统计学意(χ2=0.003,P>0.05),而TNBC组阳性率较Luminal A型组和Luminal B型组均明显降低,差别具有统计学意义(42.59% vs 63.27%,χ2=4.40,P<0.05,42.59% vs 63.41%,χ2=4.05,P<0.05);TNBC中E-cadherin阳性表达与年龄无关(P>0.05),与肿瘤大小、TNM分期、组织学分级、淋巴结转移状态及Ki67负相关,差别具有统计学意义(P<0.05);TNBC总体3年复发或转移率高达55.56%,无病生存率为44.44%.E-cadherin阳性组复发转移率为39.13%,E-cadherin阴性组复发转移率为67.74%,差别有统计学意义(χ2=4.38,P<0.05),3年无疾病进展时间(PFS)E-cadherin阳性组明显优于阴性组(P<0.05).结论:不同分子分型乳腺癌中E-cadherin表达不同,E-cadherin阳性表达与肿瘤大小、组织学分级、分期及浸润转移呈负相关,对预测3年复发转移有一定意义.%Objective:To investigate the expression of E-cadherin in breast cancer in different molecular type of breast cancer and its clinical significance in triple negative breast cancer(TNBC).Methods:188 cases with breast invasive ductal carcinoma in our hospital from January 2012 to December 2013 were collected.According to immuno-histochemistry technology and fluorescence in Situ Hybridization,we categorized those cases into Luminal A group(49 cases),Luminal B group(41 cases),HER-2 positive group(44 cases),and triple negative group(TNBC)(54 ca-ses).The expression of E-cadherin detected by Immunohistochemistry in breast cancer with different molecular sub-typing was determined.The relationship between E-cadherin and clinicopathologic characteristics was analyzed in TNBC.And the recurrence or metastasis rate of 54 cases with TNBC was followed up for 3 years.Results:The positive rate of E-cadherin in breast cancer was 52.13%.The positive rate of Luminal A group was 63.27%,Luminal B group was 63.41%,HER-2 positive group was 43.18%,and that of TNBC group was 42.59%.The difference of positive rate between four groups was statistically significant(χ2=7.89,P<0.05).The difference between TNBC and HER-2 positive group was not statistically significant(χ2=0.003,P>0.05),while the positive rate of TNBC group was significantly lower than that of Luminal A group and Luminal B group,and the difference was statistically significant(42.59% vs 63.27%,χ2=4.40,P<0.05 and 42.59% vs 63.41%,χ2=4.05,P<0.05).The positive expression of E-cadherin in TNBC was not related to age(P>0.05),and negatively correlated with tumour size, TNM stage,histological grade,lymph node status and vascular invasion.The difference was statistically significant(P<0.05).The overall recurrence rate and metastasis rate of TNBC was 55.56% in 3 years,and the disease-free sur-vival rate was 44.44%.The metastasis rate of E-cadherin positive group recurrence was 39.13%,the metastasis and recurrence rate of E-cadherin negative group was 67.74%,the difference was statistically significant(χ2=4.38,P<0.05),E-cadherin negative expression is prone to recurrence and metastasis.The PFS of E-cadherin positive group is better than that of E-cadherin negative group Conclusion:The expression of E-cadherin in different mo-lecular subtypes of breast cancer is different,and the positive expression of E-cadherin is negatively correlated with tumour size,histological grade,stage and invasion and metastasis.It has certain significance in predicting recurrence and metastasis in 3 years.