BCL9和β-catenin在乳腺癌中的表达及临床意义

发布时间：2018-05-14 03:37

本文选题：乳腺浸润性导管癌 + 导管原位癌　；参考：《西南医科大学》2017年硕士论文

【摘要】：目的:探讨乳腺组织中B细胞淋巴瘤因子9(B-cell lymphoma 9,BCL9)和β-链蛋白(β-catenin)的表达及其与乳腺癌临床病理特征的关系。方法:共收集乳腺癌术后标本228例,其中浸润性导管癌(invasive ductal carcinoma,IDC)120例,导管原位癌伴微浸润(ductal carcinoma in situ with microinvasion,DCIS-MI)38例,导管原位癌(ductal carcinoma in situ,DCIS)50例,乳腺癌旁正常组织20例。采用免疫组织化学Envision染色法检测BCL9及β-catenin蛋白在上述组织中的表达情况,分析其在不同组织中的表达差异、在IDC中与临床病理特征的关系及二者的相关性。应用SPSS17.0软件分析系统进行统计学处理,计数资料采用卡方检验,Fisher确切概率法对数据进行两两比较,相关性分析采用Spearman相关检验。结果以P0.05为差异有统计学意义。结果:1.BCL9在乳腺正常组织、DCIS、DCIS-MI、IDC中的表达阳性率分别为0、32%、44.7%、53.3%,四组间差异有统计学意义(P0.05)。BCL9在DCIS、DCIS-MI、IDC组表达均高于乳腺正常组织组(P0.05);IDC组表达高于DCIS组,差异有统计学意义(P0.05),DCIS-MI组表达与DCIS组、IDC组无差异(P0.05)。2.β-catenin蛋白在乳腺正常组织、DCIS、DCIS-MI、IDC中的异常表达率分别为20%、56%、60.5%、71.7%,四组间差异有统计学意义(P0.05)。其中β-catenin异常表达率在DCIS、DCIS-MI、IDC组中高于正常组织组,差异均具有统计学意义(P0.05);IDC组异常表达率高于DCIS组(P0.05),然而DCIS-MI组与IDC组、DCIS组之间无差异(P0.05)。3.BCL9表达与肿瘤大小、ER、PR、HER-2表达、Ki-67及分子分型相关(P0.05),与患者年龄、WHO分级、脉管瘤栓、淋巴结转移、远处转移及肿瘤p TNM分期无关(P0.05)。4.β-catenin表达与脉管瘤栓、ER、HER-2表达、分子分型相关(P0.05),与患者年龄、肿瘤大小、淋巴结转移、远处转移、WHO分级、肿瘤p TNM分期及PR、Ki-67无关(P0.05)。5.经Spearman相关检验分析得出在乳腺癌中BCL9阳性表达和β-catenin蛋白异常表达呈正相关关系(r=0.612,P=0.000)。结论:1.在乳腺正常组织、DCIS、DCIS-MI、IDC中BCL9表达逐渐增加,提示BCL9可能与乳腺肿瘤发生及肿瘤进展相关;IDC组表达高于DCIS组,提示BCL9可能与导管原位癌发生浸润相关。2.β-catenin在乳腺正常组织、DCIS、DCIS-MI、IDC四组异常表达率呈递增趋势,β-catenin的异常表达可能与乳腺癌的发生及肿瘤进展相关;IDC组β-catenin异常表达率高于DCIS组,提示β-catenin的异常表达可能与导管原位癌发生浸润相关。3.在IDC中肿瘤T分期越晚、ER(-)、PR(-)、HER-2阳性表达、Ki-67高表达患者BCL9阳性率越高;分子分型为Basal-like型、HER-2过表达型、Luminal B型的乳腺癌患者BCL9阳性率高于Luminal A型。4.在IDC中肿瘤伴脉管瘤栓、ER阴性、HER-2阳性者β-catenin异常表达率更高,分子分型为Basal-like型、HER-2过表达型、Luminal B型β-catenin异常表达率高于Luminal A型。5.在乳腺癌中,BCL9阳性表达和β-catenin异常表达呈正相关。
[Abstract]:Objective: to investigate the expression of B cell lymphoma factor 9(B-cell lymphoma 9 (BCL9) and 尾-chain protein (尾-catenin) and its relationship with clinicopathological features of breast cancer. Methods: a total of 228 cases of breast cancer were collected, including 120 cases of invasive ductal carcinoma, 38 cases of ductal carcinoma in situ with microinvasion-DCIS-MIM, 50 cases of ductal carcinoma in situ, and 20 cases of normal tissue adjacent to breast cancer. Immunohistochemical Envision staining was used to detect the expression of BCL9 and 尾 -catenin in these tissues. The differences of expression in different tissues, the relationship between the expression of BCL9 and 尾 -catenin in IDC and their correlation with clinicopathological features were analyzed. The SPSS17.0 software analysis system is used to deal with statistics, the counting data is compared by chi-square test and Fisher exact probability method, and the correlation analysis adopts Spearman correlation test. Results there was a significant difference between the two groups. Results 1. The positive rate of BCL9 expression in DCIS-MI-IDC in normal breast tissue was 0.32, 44.7 and 53.3, respectively. The expression of BCL9 in DCIS-MIIS-IDC group was significantly higher than that in normal breast tissue group (P0.05IDC), and the expression of BCL9 in DCIS-MI-IDC group was higher than that in normal breast tissue group (P0.05IDC group), and the positive rate of BCL9 expression in DCIS-MI-IDC group was higher than that in normal breast tissue group (P0.05IDC group). There was no significant difference in the expression of 尾 -catenin in DCIS-MI group and DCIS group. The abnormal expression rate of 尾 -catenin protein in DCIS-MI-IDC in normal breast tissue was 20 ~ 5656-MI-IDC, respectively. The difference between the four groups was significant (P 0.05). The abnormal expression rate of 尾 -catenin in DCIS-MI-IDC group was higher than that in normal tissue group. The difference was statistically significant (P 0.05). The abnormal expression rate in IDC group was higher than that in DCIS group. However, there was no difference between DCIS-MI group and IDC group. 3. The expression of BCL9 was correlated with the expression of Ki-67 and molecular type of P0.05, tumor thrombus and lymph node metastasis. The expression of 尾 -catenin was not correlated with the expression of ERHER-2 in vascular tumor thrombus, but not with age, tumor size, lymph node metastasis, distant metastasis grade, tumor p TNM stage and Ki-67 p0.05.5.The expression of 尾 -catenin was not correlated with tumor age, tumor size, lymph node metastasis, distant metastasis and p0.05n.4. 尾 -catenin expression was not associated with the expression of ERHER-2, and the expression of 尾 -catenin was not correlated with age, tumor size, lymph node metastasis. The positive expression of BCL9 and the abnormal expression of 尾 -catenin protein were positively correlated with the expression of 尾 -catenin protein in breast cancer by Spearman correlation test. Conclusion 1. The expression of BCL9 in DCIS-MI-IDC was gradually increased in normal breast tissue, suggesting that the expression of BCL9 in IDC group may be higher than that in DCIS group, which may be related to the occurrence and progression of breast tumor. These results suggest that the abnormal expression rate of 尾 -catenin may be increased in DCIS-MI-IDC group. The abnormal expression of 尾 -catenin may be associated with the occurrence and progression of breast cancer. The abnormal expression rate of 尾 -catenin in IDC group is higher than that in DCIS group. These results suggest that the abnormal expression of 尾-catenin may be related to the invasion of ductal carcinoma in situ. The higher the expression of Ki-67, the higher the positive rate of BCL9 in patients with higher expression of HER-2 in IDC, and the higher the positive rate of BCL9 in breast cancer with Basal-like and HER-2 overexpression type B is higher than that in type Luminal A. The abnormal expression rate of 尾 -catenin was higher in patients with ER negative or HER-2 positive in IDC, and the abnormal expression rate of 尾 -catenin in Basal-like type HER-2 overexpression type was higher than that in Luminal A type. 5. Positive expression of BCL9 and abnormal expression of 尾-catenin were positively correlated in breast cancer.
【学位授予单位】：西南医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R737.9

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