Bcl-2、Caspase-3在乳腺癌骨转移患者组织中的表达及相关性研究初探

发布时间：2018-06-05 07:53

本文选题：乳腺癌 + 骨转移　；参考：《川北医学院》2017年硕士论文

【摘要】：目的:探讨Bcl-2、Caspase-3在乳腺癌骨转移患者组织中的表达及意义,进一步分析两者与乳腺癌骨转移临床病理学参数间的关系,探寻乳腺癌骨转移的风险因素。方法:分别纳入乳腺癌骨转移患者40例、乳腺癌无骨转移患者30例、乳腺良性增生患者30例,对所有病例行免疫组织化学检测Bcl-2、Caspase-3的表达情况,分析乳腺癌骨转移患者的全身骨显像特点,乳腺癌骨转移与Bcl-2、Caspase-3表达之间的相关性以及两者与乳腺癌骨转移临床病理学参数之间的关系。结果:1.乳腺癌骨转移至脊柱占60%,高于胸部(57.5%)、骨盆(42.5%)、四肢(20%)和颅骨(7.5%),差异显著(χ2=36.380,P0.01)。2.Bcl-2在70例乳腺癌组织中的阳性表达率为71.4%,明显高于乳腺良性增生组(46.7%),具有统计学意义(χ2=5.589,P0.05);Bcl-2在乳腺癌骨转移组中的阳性表达率为72.5%,稍高于乳腺癌无骨转移组(70%),但两者差异无统计学意义(χ2=0.053,P0.05)。3.Caspase-3在70例乳腺癌组织中的阳性表达率为82.6%,稍高于乳腺良性增生组(80%),但两者差异不具有统计学意义(χ2=0.116,P0.05);Caspase-3在乳腺癌骨转移组中的阳性表达率为92.5%,明显高于乳腺癌无骨转移组(70%),两者差异具有统计学意义(χ2=6.11,P0.05)。4.乳腺癌骨转移患者中Bcl-2的阳性表达率与ER、PR的表达情况有关,具有统计学差异(χ21=7.595,P10.01;χ22=5.021,P20.05),且呈正相关(r1=0.498,P10.01;r2=0.411,P20.01),而与其他临床病理学参数(年龄、肿瘤直径、腋淋巴结转移、组织学分级、HER-2及Ki-67表达)均无关(P0.05)。5.乳腺癌骨转移患者中Caspase-3的阳性表达率与各临床病理学参数(年龄、肿瘤直径、腋淋巴结转移、组织学分级、ER、PR、HER-2及Ki-67表达)均无关(P0.05)。6.Bcl-2、Caspase-3两者在乳腺癌组织中的表达不具有相关性(P0.05)。7.乳腺癌骨转移与Caspase-3阳性表达有关,Caspase-3阳性组骨转移率(62.7%)明显高于阴性组(27.2%),两者差异具有统计学意义(χ2=4.755,P0.05);乳腺癌骨转移与腋淋巴结转移有关,乳腺癌患者腋淋巴结转移组骨转移率(69.7%)高于无腋淋巴结转移组(45.9%),差异具有统计学意义(χ2=4.018,P0.05);乳腺癌骨转移与其他临床病理学因素(年龄、肿瘤直径、组织学分级、Bcl-2、ER、PR、HER-2及Ki-67表达)无关(P0.05)。结论:1.Bcl-2、Caspase-3在乳腺癌组织中都是高表达,二者间不具有相关性,提示其介导的细胞凋亡途径在乳腺癌的发生发展过程中发挥着重要作用,可以为乳腺诊断与治疗提供新的靶点选择;2.Bcl-2表达在乳腺癌有无骨转移组间没有差异,但与患者ER、PR呈正相关,提示Bcl-2的表达情况可能作为乳腺癌骨转移患者是否选择内分泌治疗的依据之一;3.Caspase-3表达在乳腺癌有无骨转移组间差异明显,提示Caspase-3高表达与乳腺癌骨转移有关,与腋淋巴结转移一样,可能是乳腺癌发生骨转移的风险因素。
[Abstract]:Objective: to investigate the expression and significance of Bcl-2Caspase-3 in breast cancer patients with bone metastasis, to further analyze the relationship between Bcl-2Caspase-3 and clinicopathological parameters of breast cancer bone metastasis, and to explore the risk factors of breast cancer bone metastasis. Methods: 40 cases of breast cancer with bone metastasis, 30 cases of breast cancer without bone metastasis and 30 cases of benign hyperplasia of mammary gland were included. The expression of Bcl-2Caspase-3 was detected by immunohistochemistry in all cases. To analyze the characteristics of bone imaging in patients with bone metastasis of breast cancer, the correlation between bone metastasis of breast cancer and the expression of Bcl-2Caspase-3, and the relationship between them and clinicopathological parameters of bone metastasis of breast cancer. The result is 1: 1. The breast cancer bone metastasis to the spinal column accounted for 60 cases, which was higher than that of the thoracic cavity 57.5%, the pelvic cavity 42.5 and the extremities 20%. There was a significant difference between the breast cancer bone and the cranial bone. The positive expression rate of Bcl-2 in 70 cases of breast cancer was 71.4, which was significantly higher than that in the benign hyperplasia group (蠂 2 5.589 P 0.05 P 0.05), and there was a significant difference between the two groups (蠂 2, 5.589, P 0.05, P 0.05), and the positive expression rate of Bcl-2 in 70 cases of breast cancer was 71.4, which was significantly higher than that in the benign hyperplasia of the breast (蠂 2 5.589 P 0.05). The positive expression rate of Caspase-3 in adenocarcinoma bone metastasis group was 72.5, which was slightly higher than that in breast cancer without bone metastasis group, but there was no significant difference between the two groups (蠂 2, 0.053, P 0.05, P 0.05. 3. The positive expression rate of Caspase-3 in 70 breast cancer tissues was 82.6, slightly higher than that in breast benign hyperplasia group, but the positive expression rate of Caspase-3 in 70 breast cancer tissues was 82.6, but both were higher than those in breast benign hyperplasia group. The positive expression rate of Caspase-3 in breast cancer bone metastasis group was 92.5, which was significantly higher than that in breast cancer without bone metastasis group. The positive expression rate of Bcl-2 was correlated with the expression of ERP PR in patients with bone metastasis of breast cancer (蠂 217.595, P 10.01; 蠂 2 22, 5.021, P 20.05, P 20.05), and was positively correlated with other clinicopathological parameters (age, tumor diameter, axillary lymph node metastasis, P 20.01). The expression of HER-2 and Ki-67 in histopathological grading were not related to the expression of P0. 05. 5. There was no correlation between the positive expression rate of Caspase-3 and the clinicopathologic parameters (age, tumor diameter, axillary lymph node metastasis, histopathological grade of ERP / PRHER-2 and Ki-67 expression) in breast cancer. 6. Bcl-2Caspase-3 expression was not correlated with the expression of P0.05. 7 in breast cancer. The bone metastasis rate of breast cancer with positive expression of Caspase-3 was significantly higher than that of negative group. The difference was statistically significant (蠂 2 + 4.755% P 0.05), and the bone metastasis of breast cancer was related to axillary lymph node metastasis. The rate of bone metastasis in patients with axillary lymph node metastasis was 69.7%, which was significantly higher than that in patients without axillary lymph node metastasis (蠂 2 / 4.018 / P 0.05), and there was no correlation between bone metastasis and other clinicopathological factors (age, tumor diameter, histological grade Bcl-2ERP / PRHER-2 and Ki-67 expression). Conclusion: 1. Bcl-2Caspase-3 is highly expressed in breast cancer tissues, and there is no correlation between them, suggesting that the apoptosis pathway mediated by Bcl-2Caspase-3 plays an important role in the occurrence and development of breast cancer. 2. There was no difference between the expression of Bcl-2 in breast cancer with or without bone metastasis, but it was positively correlated with ERP. The results suggest that the expression of Bcl-2 may be one of the bases for the selection of endocrine therapy in patients with bone metastasis of breast cancer. 3. The expression of Caspase-3 is significantly different between the groups with or without bone metastasis of breast cancer, suggesting that the high expression of Caspase-3 is related to bone metastasis of breast cancer. As with axillary lymph node metastasis, it may be a risk factor for bone metastasis in breast cancer.
【学位授予单位】：川北医学院
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R737.9

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