乳腺癌分子分型临床病理特点与耐药基因表达分析

发布时间：2018-02-12 05:41

  本文关键词： 乳腺癌 分子分型 临床病理特征 耐药基因　出处：《安徽医科大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:探讨乳腺癌各个分子分型的临床病理特点,对每种分子分型中相关耐药基因表达有无差异进行研究,分析各分子分型乳腺癌与细胞毒药物敏感性相关关系,为临床不同分子分型乳腺癌化疗提供依据。方法:收集并分析2014年1月~2016年12月在我科手术的乳腺癌患者信息,入组156例,发病年龄24~78岁,中位年龄48岁的乳腺癌患者,根据ER(Estrogen Receptor,雌激素受体)、PR(Progesterone Receptor,孕激素受体)、Her-2(Human Epidermal Growth Factor Receptor 2,人类表皮生长因子受体2)、Ki-67的表达的情况,划分为4个分子亚型:Luminal A型、Luminal B型、Her-2过表达型、Basal-Like型,对比分析4种分子分型患者的发病率、年龄分布特点和临床病理特征与分子分型之间有无相关性。同时,通过现有病理资料,分析不同分子分型中三种耐药基因P-gp(P-glycoprotein)、GST-π(Glutathione-S-Transferase-π)、Topo II(Topoisomerase II)的表达差异,为临床治疗方案选择提供方向。结果:入组乳腺癌4种分子分型中,Luminal A型67例(42.9%),Lumin al B型44例(28.2%),Her-2过表达型21例(13.5%),Basal-Like型24例(15.4%);分子亚型在年龄阶段分布无统计学差异(P0.05);肿瘤T分期分布无统计学差异(P0.05);淋巴结阳性情况及TNM分期有统计学差异(P0.05),三种耐药基因在4种分子分型乳腺癌患者中表达具有统计学差异(P0.05),P-gp阳性的病例数为83例,53.2%。Luminal B型P-gp阳性达79.5%,提示更容易产生耐药;Basal-Like型P-gp表达较低33.3%。GST-π表达该基因比例较低48例(30.8%),其中Basal-Like过表达型表达率最高达15例(62.5%),Luminal A表达率最低较低共12例(17.9%)。TopoⅡ表达共90例(57.7%),其中Her-2表达最高18例(85.7%),Basal-Like最低6例(29.2%)。结论:乳腺癌分子分型与临床治疗的敏感性及预后有相关性,能够反映乳腺癌的生物学特点,对于该类疾病治疗方案及病患预后预测有指导价值。
[Abstract]:Objective: to investigate the clinicopathological characteristics of each molecular type of breast cancer, to study the differences in the expression of related drug resistance genes in each molecular classification, and to analyze the relationship between each molecular type of breast cancer and cytotoxic drug sensitivity. Methods: from January 2014 to December 2016, we collected and analyzed the information of 156 breast cancer patients who had been operated in our department from January 2014 to December 2016. The age of breast cancer was 2478 years old and the median age was 48 years old. According to the expression of ER(Estrogen receptor, estrogen receptor progesterone receptor, progesterone receptor, progesterone receptor Her-2human Epidermal Growth Factor Receptor 2 and human epidermal growth factor receptor 2ki-67, four molecular subtypes are classified as Basal-Like type. The incidence, age distribution, clinicopathological characteristics and molecular typing of the patients with four molecular types were compared and analyzed. At the same time, based on the existing pathological data, To analyze the difference of expression of three drug resistance genes (P-gpCP-glycoprotein) GST- 蟺 -Glutathione-S-Transferase- 蟺 / Topo II(Topoisomerase II in different molecular typing, and to analyze the expression of GST- 蟺 -Glutathione-S-Transferase- 蟺 in different molecular typing. Results: among the 4 molecular types of breast cancer, 67 cases of Luminal A type and 44 cases of Lumin al type B had Her-2 overexpression in 21 cases with 13.5B type Basal-Like type (24 cases), and there was no significant difference in the distribution of molecular subtypes in age stage (P 0.05). There was no statistical difference in the distribution of tumor T stage (P 0.05), the positive status of lymph nodes and TNM stage were significantly different (P 0.05). The number of patients with three drug resistance genes expressed in 4 molecular type breast cancer patients with P 0.05 P GP positive was 83 cases. 53.2.The positive rate of P-gp of Luminal B was 79.5a, which suggested that the expression of P-gp of Basal-Like type was more likely to produce a lower expression rate of 33.3.GST- 蟺 in 48 patients with lower expression of this gene. The highest expression rate of Basal-Like overexpression type was up to 62.5Luminal A in 15 cases. The lowest expression rate of PGP 鈪，

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