丝裂原活化蛋白激酶激酶4和雌激素受体的表达在浸润性乳腺癌组织中的临床意义

摘要

目的 探讨丝裂原活化蛋白激酶激酶4(MAP2K4)在乳腺癌组织中的表达情况,并分析其表达与乳腺癌病理特征和预后以及与雌激素受体表达的相关性.方法 运用免疫组织化学SP法检测102例乳腺癌组织中MAP2K4的表达,MAP2K4在乳腺癌中的表达及其与临床病理参数之间的关系采用卡方检验.生存分析用Kaplan-Meier法和Log Rank统计检验进行分析;多因素生存分析采用Cox比例风险回归模型.MAP2K4和ER表达之间的相关性分析采用Spearman相关分析.结果 102例组织标本中MAP2K4低表达有57例(57/102,55.9%),高表达有45例(45/102,44.1%);MAP2K4的表达在乳腺癌中不同病理分级(P=0.011)中差异显著;Kaplan-Meier生存分析显示,MAP2K4高表达患者的生存时间低于低表达患者(P=0.002);COX回归分析提示,MAP2K4高表达是影响乳腺癌患者预后的独立因素(P=0.009);等级相关分析显示MAP2K4的表达与雌激素(r=-0.093)无明显相关性,但MAP2K4高表达与雌激素阴性患者展示了最差的生存预后.结论 高表达MAP2K4促进了乳腺癌患者进展和不利的预后.MAP2K4高表达与雌激素阴性乳腺癌患者综合生存时间最短,提示联合检测MAP2K4和雌激素表达可以进一步精确监控乳腺癌患者预后.%Objective To explore the association of mitogen-activated protein kinase kinase-4 (MAP2K4) with the pathological features, prognosis and expression of estrogen receptor (ER) in patients with breast cancer. Methods The expression of MAP2K4 was detected immunohistochemically in 102 breast cancer tissues. Chi square test was used to analyze the correlation of MAP2K4 expression with the clinicopathological features of the patients. Kaplan-Meier and log rank test were used for survival analysis of the patients. Multivariate survival analysis was performed using Cox proportional hazard regression model. The correlation between the expressionsof MAP2K4 and ER was investigated using Spearman rank correlation test. Results Immunohistochemical analysis revealed low MAP2K4 expression in 55.9%(57/102) and high MAP2K4 expression in 44.1%(45/102) of the breast cancer tissues. The expression of MAP2K4 was significantly correlated with the pathological grades of breast cancer (P=0.011). Kaplan-Meier survival analysis showed that patients with a high expression of MAP2K4 had a shorter overall survival rate than those with low MAP2K4 expressions (P=0.009). Multivariate analysis identified high expression of MAP2K4 as the independent predictor of a poor outcome of patients with breast cancer. The expressions of MAP2K4 and ER were not significantly correlated, but ER-negative patients with a high MAP2K4 expressionshowed the shortest overall survival time. Conclusion Overexpression of MAP2K4 promotes the progression in breast cancer and is associated with a poor outcome of the patients. TheER-negativepatients with a high MAP2K4 expression have the shortest overall survival time, suggestingthe value of combined examination of MAP2K4 and ER in accurate estimation of the prognosis of breast cancer patients.