p53、Ki-67及E-cadherin在三阴性乳腺癌中表达的相关性研究

发布时间：2018-12-18 09:37

【摘要】：目的:检测三阴性乳腺癌(triple negative breast cancer,TNBC)、非三阴性乳腺癌(non-triple negative breast cancer,NTNBC)组织中的p53、Ki-67、及E-cadherin蛋白表达,探讨三个指标与TNBC临床病理特征的关系,以及三种蛋白表达的相关性。并结合临床随访资料,分析上述三种蛋白的表达与TNBC患者预后的关系。方法:采用免疫组织化学染色二步法分别检测52例TNBC、52例NTNBC中p53、Ki-67、及E-cadherin蛋白表达,分析其与TNBC患者预后的关系。结果:1.TNBC、NTNBC中p53阳性表达率分别为67.3%、44.2%,TNBC组织中p53阳性表达率高于NTNBC(χ2=5.613,P=0.018);在TNBC组织中,p53阳性表达与组织学分级、肿瘤大小、TNM分期有关(均P0.05),但与患者淋巴结转移、年龄、绝经状态无关(均P0.05);生存曲线显示TNBC组织中p53阴性表达患者总体生存率显著高于阳性者(P0.05)。2.TNBC、NTNBC中Ki-67阳性表达率分别为80.8%、61.5%,TNBC组织中Ki-67阳性表达率高于NTNBC(χ2=4.685,P=0.030);在TNBC组织中,Ki-67表达阳性与淋巴结转移、TNM分期有关(均P0.05),但与患者肿瘤大小、年龄、组织学分级、绝经状态无关(均P0.05);生存曲线显示TNBC组织中Ki-67阴性表达患者总体生存率显著高于阳性者(P0.05)。3.TNBC、NTNBC中E-cadherin阳性表达率分别为26.9%、48.1%,TNBC组织中E-cadherin阳性表达率低于NTNBC组织(χ2=4.964,P=0.026);在TNBC组织中,E-cadherin表达阳性与肿瘤大小、淋巴结转移、TNM分期有关(均P0.05),但与患者组织学分级、年龄、绝经状态无关(均P0.05);生存曲线显示TNBC组织中E-cadherin阳性表达患者总体生存率显著高于阴性者(P0.05)。4.生存曲线显示在TNBC组织中p53、Ki-67阴性及E-cadherin阳性共表达患者的总体生存率显著高于p53、Ki-67阳性及E-cadherin阴性共表达患者(P0.05)。5.在TNBC组织中,p53、Ki-67阳性表达呈正相关(r=0.388,P=0.004),p53、E-cadherin阳性表达呈负相关(r=-0.686,P=0.000),Ki-67、E-cadherin阳性表达呈负相关(r=-0.584,P=0.000)。6.Cox回归分析单因素显示,肿瘤大小、TNM分期、淋巴结转移、p53、Ki-67及E-cadherin表达是影响三阴性乳腺癌患者总体生存率的显著因素(均P0.05)。Cox回归分析多因素显示,p53、Ki-67及E-cadherin表达、淋巴结转移是影响三阴性乳腺癌患者总体生存率的独立预后因素(均P0.05)。结论:1.p53、Ki-67在三阴性乳腺癌组织中高表达,其阳性表达者预后差;E-cadherin在三阴性乳腺癌组织中低表达,其阴性表达者预后差。2.p53、Ki-67及E-cadherin可能参与三阴性乳腺癌的发生、发展及浸润、转移;联合检测p53、Ki-67及E-cadherin在三阴性乳腺癌中的表达可为患者提供分子治疗的新靶点。
[Abstract]:Objective: to detect the expression of p53 Ki-67 and E-cadherin protein in (triple negative breast cancer,TNBC, non-triple-negative breast cancer (non-triple negative breast cancer,NTNBC), and to explore the relationship between the three markers and the clinicopathological features of TNBC. And the correlation between the expression of three proteins. The relationship between the expression of these three proteins and the prognosis of TNBC patients was analyzed. Methods: the expression of p53 Ki-67 and E-cadherin protein were detected by immunohistochemical staining in 52 cases of TNBC,52 with NTNBC. The relationship between the expression of p53 Ki-67 and the prognosis of TNBC was analyzed. Results: 1. The positive expression rate of p53 in TNBC was 67.3 and 44.2, respectively, which was higher than that in NTNBC (蠂 2 = 5.613). In TNBC, p53 positive expression was related to histological grade, tumor size and TNM stage (P0.05), but not to lymph node metastasis, age and menopausal status (P0.05). Survival curve showed that the overall survival rate of patients with p53 negative expression in TNBC was significantly higher than that of positive patients (P0.05). 2. The positive expression rate of Ki-67 in TNBCnTBC was 80.8% and 61.5%, respectively. The positive expression rate of Ki-67 in TNBC was higher than that in NTNBC (蠂 2 + 4.685% P0.030). In TNBC, the positive expression of Ki-67 was related to lymph node metastasis and TNM stage (P0.05), but not to tumor size, age, histological grade and menopausal status (P0.05). Survival curve showed that the overall survival rate of patients with negative expression of Ki-67 in TNBC was significantly higher than that of patients with positive expression (P0.05). 3. The positive expression rate of E-cadherin in NTNBC was 26.9% and 48.1%, respectively. The positive expression rate of E-cadherin in TNBC was lower than that in NTNBC (蠂 2 / 4.964). In TNBC, the positive expression of E-cadherin was related to tumor size, lymph node metastasis and TNM stage (P0.05), but not related to histological grade, age and menopausal status (P0.05). Survival curve showed that the overall survival rate of E-cadherin positive expression patients in TNBC was significantly higher than that of negative patients (P0.05). Survival curve showed that the overall survival rate of patients with p53 Ki-67 and E-cadherin positive co-expression in TNBC was significantly higher than that in p53 Ki-67 positive and E-cadherin negative co-expression (P0.05). In TNBC, the positive expression of p53 Ki-67 was positively correlated with that of p538, E-cadherin (r-0.686) and Ki-67,E-cadherin (r-0.584), and the expression of E-cadherin was negatively correlated with that of p53- 0.686, and that of Ki-67,E-cadherin was negatively correlated with that of p53-p538, E-cadherin and Ki-67,E-cadherin (r-0.584, r = 0.584), respectively. 6.Cox regression analysis showed that the tumor size, TNM stage, lymph node metastasis, p53, p53, The expression of Ki-67 and E-cadherin was a significant factor influencing the overall survival rate of patients with triple-negative breast cancer (P0.05). Cox regression analysis showed that the expression of p53 Ki-67 and E-cadherin was significant in patients with breast cancer. Lymph node metastasis was an independent prognostic factor for the overall survival rate of triple negative breast cancer patients (P0.05). Conclusion: 1. The expression of p53 Ki-67 is high in tri-negative breast cancer, and the prognosis of the patients with positive expression is poor; The prognosis of patients with low expression of E-cadherin in tri-negative breast cancer is poor. 2.p53 Ki-67 and E-cadherin may be involved in the occurrence, development, invasion and metastasis of tri-negative breast cancer. Combined detection of p53 Ki-67 and E-cadherin in tri-negative breast cancer may provide a new target for molecular therapy.
【学位授予单位】：江苏大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R737.9

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