协和医学杂志

2015, (1)

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三阴乳腺癌与非三阴乳腺癌临床病理特征差异及与雌激素受体β和表皮生长因子受体表达的关系
Expression and significance of ERβ,EGFR,P53 and Ki67 in triple negative breast cancer and non-triple negative breast cancer

袁礼;吴焕文;任新瑜;梁智勇

摘要(Abstract):

【摘要】 目的 本研究旨在分析三阴乳腺癌与非三阴乳腺癌在临床病理特征及ERβ、EGFR、P53、Ki67等免疫组织化学指标表达上的差异,并进一步探讨临床病理特征以及上述指标的表达与三阴乳腺癌预后的关系。方法 收集2010年1月至2013年12月北京协和医院收治的经组织病理诊断证实的乳腺癌患者共863例。其中三阴乳腺癌135例。采用回顾性分析的方法,分析三阴乳腺癌与非三阴乳腺癌在年龄、病理类型、肿瘤大小、分化程度、肿瘤分期、是否有淋巴结转移、是否累及乳头以及手术方式等临床病理特征方面的差异。通过免疫组织化学法检测ERβ、EGFR、P53、Ki67在三阴乳腺癌与非三阴乳腺癌中的表达情况,分析上述指标在两类乳腺癌中的表达差异。进一步通过单因素生存分析探讨135例三阴乳腺癌患者中的预后相关因素。结果 结果显示三阴乳腺癌中浸润性导管癌的比例高于非三阴乳腺癌(P<0.01),发病年龄小于非三阴乳腺癌(P<0.05);三阴乳腺癌与非三阴乳腺癌之间的淋巴结转移、肿瘤大小、分化程度、手术方式、肿瘤分期亦存在显著差异(P<0.05);三阴乳腺癌与非三阴乳腺癌在肿瘤是否累及乳头上的差异无统计学意义(P>0.05);免疫组化结果显示,与非三阴乳腺癌相比,三阴乳腺癌中ERβ阳性表达率显著降低,而EGFR阳性表达率显著升高(P<0.05);Ki67、P53在三阴乳腺癌与非三阴乳腺癌表达无显著差异(P>0.05);三阴乳腺癌比非三阴乳腺癌的无复发生存率(relapse free survival, RFS)和总体生存率(overall survival, OS)更低(P<0.01)。在三阴乳腺癌中的单因素生存分析显示,ERβ阴性与EGFR阳性表达均与三阴乳腺癌的不良预后相关(P<0.05)。结论 相较与非三阴乳腺癌,三阴乳腺癌有明显不同的临床病理特征:发病年龄较低、原发肿瘤体积较大、分化程度低、易发生淋巴结转移、ERβ阳性表达率较低、EGFR阳性表达率较高、RFS及OS低。ERβ、EGFR可能成为重要的三阴乳腺癌预后判断指标。
【Abstract】 Objective This study aims to analyze the differences in clinicopathologic features and expression of ERβ,EGFR,P53and Ki67 of triple negative breast cancer and non-triple negative breast cancer. Methods 863 patients with breast cancer which confirmed by histopathology were collected in Peking Union Medical College Hospital from January 2010 to December 2013. By retrospective analysis methods, analysis the differences in the onset age, pathological type, maximum diameter of the tumor, the degree of the tumor differentiation, tumor stages, lymph node metastasis, whether involving the nipple and operation mode of triple negative breast cancer and non-triple negative breast cancer. Analysis the differences between triple negative breast cancer and non-triple negative breast cancer in the expression of ERβ,EGFR,P53and Ki67 by immunohistochemical staining. Further analysis discusses the relevant factors which affect the prognosis of the triple negative breast cancer by univariate survival analysis. Results The proportion of invasive ductal carcinoma in triple negative breast cancer was higher than non-triple negative breast cancer (P<0.01);the age of onset was less in triple negative breast cancer(P<0.05);and there were significant differences in lymph node metastasis, tumor sizes, differentiation degree, tumor stages between them (P<0.05);There were no statistical significance in whether the tumor was involving the nipple(P>0.05).Immunohistochemistry results showed that, compared with non-triple negative breast cancer, the positive expression rate of ERβdecreases significantly while the positive expression rate of EGFR and was significantly increased in triple negative breast cancer(P<0.05); the expression of P53 and Ki67 had no significant differences(P>0.05);the overall survival(OS) and relapse free survival(RFS)was lower in triple negative breast cancer(P<0.01).Single factor analysis showed the negative expression of ERβand positive expression of EGFR were related to the poor prognosis of triple negative breast cancer(P<0.05).Conclusion Compared to non-triple negative breast cancer, triple negative breast cancer showed completely different clinicopathologic features: age of onset is lower, the size of primary tumor is larger, the higher incidence rate of lymph node metastasis, the positive expression rate of ERβis lower, the positive expression of EGFR is higher, and with lower overall survival and relapse free survival.ERβand EGFR may become important prognostic indicators of triple negative breast cancer.

关键词(KeyWords): |【关键词】 三阴乳腺癌|ERβ|EGFR|P53|Ki67|临床病理特征|预后|
|【Key Words】 triple negative breast cancer|ERβ|EGFR|P53|Ki67|clinicopathogic features|prognosis|

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作者(Author): 袁礼;吴焕文;任新瑜;梁智勇

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