乳腺癌患者HER-2、PCNA和E-cadherin蛋白表达及临床病理特征与预后的相关性

摘要

目的:探讨乳腺癌组织中HER-2、PCNA和E-cadherin蛋白表达,分析它们与乳腺癌临床病理特征的关系,并探讨三者及临床病理特征与乳腺癌预后的关系.方法:应用SP免疫组化方法检测70例浸润性乳腺癌组织和10例乳腺纤维腺瘤病变中HER-2、PCNA和E-cadherin蛋白的表达.结果:HER-2、PCNA和E-cadherin在乳腺癌组织中的高表达率分别为58.57%、64.29%、40.00%,与乳腺纤维腺瘤组相比差异均有统计学意义(P<0.01).乳腺癌组织中三者的表达均与临床TNM分期、组织学分级、淋巴结转移数目密切相关(P<0.05),另外,HER-2的表达与雌激素受体(ER),E-cadherin的表达与肿瘤大小亦密切相关(P<0.05).Kaplan-Meier生存曲线分析显示随着HER-2、PCNA蛋白表达的增多、淋巴结转移数目的增加及临床分期级别的增高,患者的生存率均明显下降(P<0.01).多因素Cox回归分析表明,HER-2和临床TNM分期均为乳腺癌患者独立的远期预后指标(P<0.05).结论:乳腺癌中HER-2和PCNA的过表达,及E-cadherin表达的缺失与肿瘤的发生发展、增殖、侵袭转移及预后密切相关.联合检测HER-2、PCNA和E-cadherin有助于筛选出具有高复发及转移危险的患者,从而指导临床治疗.%Objective:To discuss the expression of HER-2,PCNA and E-cadherin and the relationship with clinical pathological parameters in breast carcinoma and their correlation with prognosis.Methods:With SP immunohistochemistry,the expression of HER-2,PCNA and E-cadherin was evaluated in 70 samples with invasive breast carcinoma,and 10 samples with breast fibroadenoma.Results:The high expression rates of HER-2,PCNA and E-cadherin in breast carcinoma were 58.57%,64.29% and 40.00% respectively,which were significantly different with that in breast fibroadenoma(P<0.01).The expression of both of them in breast carcinoma had close correlation with the clinical TNM stage,histological grade,lymph node metastasis(P<0.05),but the expression of HER-2 also had close correlation with ER(P<0.05),and the expression of E-cadherin also had close correlation with tumor size(P<0.05).Kaplan-Meier survival curve showed that patients with higher expression of HER-2 and PCNA,more number of lymph node metastasis and higher clinical TNM stage were worse than the corresponding ones,with significant differences(P<0.01).Cox multivariate regression analysis showed that HER-2 and clinical TNM stage both could be independent prognostic indicators in breast carcinoma(P<0.05).Conclusion:The up-regulated expression of HER-2 and PCNA as well as deletion of E-cadherin are involved in progression,metastasis and invasion of breast carcinoma and indicate poor prognosis.Combined detection of HER-2,PCNA and E-cadherin would be helpful in screening the patients with high risks of recurrence and metastasis,thus can be good for further treatment.