1267例乳腺癌临床与免疫组化指标的相关性分析
刘红艳①②宋丰举①
雷蕾①郑红①李海欣①陈可欣①
摘要
目的：
分析乳腺浸润性导管癌的临床特征及6种免疫组化指标表达的关系，探讨其临床意义。方法：采用免疫组化SP 法对1267例乳腺癌患者的术后肿瘤石蜡标本进行ER 、PR 、C-erbB-2、P53、Ki-67、VEGF 检测，并与患者的临床特征进行相关分析。结果：乳腺癌组织中ER 、PR 、C-erbB-2的阳性表达率分别为61.4%、53.0%、36.6%；P53、Ki-67、VEGF 的阳性表达率分别为42.0%、91.6%、74.7%。肿瘤直径≤2cm 组中，ER 和PR 表达率最高（66.8%和58.8%），而C-erbB-2的表达率最低（32.9%）。在低年龄组（≤50岁）和临床I 期的患者中，PR 表达率均最高，为57.9%和58.5%。C-erbB-2在临床晚期（Ⅲ，Ⅳ期）表达率最高（45.9%）。P53、Ki-67的阳性表达均与ER 阳性表达呈负相关。而P53、Ki-67、VEGF 的阳性表达与C-erbB-2的表达均呈正相关。淋巴结阳性组中P53、Ki-67与ER 及P53与C-erbB-2的相关程度均较淋巴结阴性组大。结论：乳腺浸润性导管癌组织中ER 、PR 、C-erbB-2与P53、Ki-67和VEGF 之间有一定的相关性，联合检测有助于指导该类肿瘤的治疗。
关键词
乳腺癌病理特征免疫组化指标Spearman 相关系数
doi:10.3969/j.issn.1000-8179.2011.11.015
Correlation of Clinical Features with Immunohistochemical Indices of 1,267Cases of Breast Cancer
Hongyan LIU 1,Fengju SONG 2,Lei LEI 2,Hong ZHENG 2,Haixin LI 2,Kexin CHEN 2Correspondence to:Haixin LI,E-mail:Haixin_li@
1Department of Surgery,Tianjin No.4Hospital,Tianjin 300222,China
2
Department of Epidemiology and Biostatistics,Tianjin Medical University Cancer Institute and Hospital,Tianjin 300060,China
Abstract
Objective:To explore the correlation between the clinical characteristics and the expression of six immunohistochemi-
cal indices in invasive ductal carcinoma of the breast (IDCB)and their clinical significance.Methods:The immunohistochemical SP method was used to detect the expression of ER,PR,C-erbB-2,P53,Ki-67,and VEGF in the postoperative paraffin blocks of 1267ID-CB cases,and the positive expression rate was compared among the different subgroups.Results:The positive expression rates of ER,PR,C-erbB-2,P53,Ki-67,and VEGF among the 1,267breast cancer cases were 61.4%,53.0%,36.6%,42.0%,91.6%,and 74.7%,pared with the groups with larger tumors,the positive expression rates of ER and PR were both the highest in the groups with the small tumors (≤2cm ),and that of C-erbB-2was the lowest.The expression rate of PR was 57.9%and 58.5%,respec-tively,in the groups with lower ages (≤50years )and early-stage tumors (stage I ),which ranked the first in both groups.The C-erbB-2expression rate ranked the first among advanced patients,amounting to 45.9%.The positive expression of P53and Ki-67was negatively correlated with ER expression,whereas the expression of P53,Ki-67,and VEGF was positively correlated with C-erbB-2ex-pression.The correlation among the expression of ER,P53and Ki-67,and between the P53and C-erbB-2expression were both higher in the positive lymph node group than in the negative lymph node group.Conclusion:There is a definite correlation of the expression of ER,PR,C-erbB-2with P53,Ki67,and VEGF expression in the IDCB tissue.Unified detection will be of instructive significance in the therapy of IDCB patients.
Keywords
Breast cancer;Pathologic characteristic;Immunohistochemical index;Spearman's correlation coefficient
作者单位：①天津医科大学附属肿瘤医院肿瘤研究所流行病室，乳腺癌防治教育重点实验室，天津市肿瘤防治重点实验室（天津市300060）；②天津市第四医院外科
通信作者：李海欣haixin_li@
乳腺癌是女性最常见的一种恶性肿瘤。浸润性导管癌是浸润性乳腺癌中最常见的类型约占40%～75%，预后不佳［1］。目前检测该类患者的雌激素受体（ER ）、孕激素受体（PR ）、C-erbB-2、P53、Ki-67和血
管内皮生长因子（VEGF ）的意义主要是判断预后、指导其内分泌治疗及化疗。本研究以天津医科大学附属肿瘤医院病理确诊的1267例原发浸润性导管癌
的资料为依据，进行不同临床特征的ER 、PR 、C-erbB-2、P53、Ki-67和VEGF 等免疫组化指标表达比较，分析其相关性，对乳腺癌的预后判断及指导治
疗将具有重要的意义。1材料与方法
1.1
一般资料
收集天津医科大学附属肿瘤医院2007年10月
