nm23、CerbB-2和p53蛋白表达对乳腺癌预后的多因素分析  

Evaluation of nm23,C-erbB-2 and p53 Gene Expressions in Multivariable Analysis of Breast Cancer Prognosis

作　　者：廖春梅[1] 赵永祥[2] 胡冬煦[3] 杨进福[3] 梁维君[1] 吴胜奇[4] 朱利军[2] 阳国平[2] 

机构地区：[1]湖南师范大学医学院,湖南长沙410006 [2]中南大学湘雅三医院,湖南长沙410013 [3]中南大学湘雅二医院,湖南长沙410011 [4]湖南省肿瘤医院,湖南长沙410013

出　　处：《医学临床研究》2004年第9期969-973,共5页Journal of Clinical Research

基　　金：国家自然科学基金(NO:30000203)

摘　　要：【目的】探讨乳腺癌组织中nm23、C erbB 2和p53基因蛋白表达及其与临床病理指标和预后的关系。 【方法】应用免疫组化S P方法检测157例乳腺癌石蜡切片中nm23、C erbB 2和p53蛋白的表达;应用Kaplan Meier法及多变量Cox比例风险模型分析3种蛋白表达与预后的关系。【结果】①nm23表达率为58.0%,与肿 瘤大小、TNM分期、腋淋巴结状态和远处转移有关;C erbB 2表达率为40.8%,与患者年龄、月经状况、肿瘤大 小、TNM分期和腋淋巴结状态相关;p53表达率为42.7%,与TNM分期和腋淋巴结状态及远处转移有关;② nm23阳性表达与C erbB 2阳性表达呈负相关,与p53阳性表达呈正相关;C erbB 2阳性表达与p53阳性表达 呈负相关;③nm23阳性组生存率高于阴性组;C erbB 2阳性组生存率低于阴性组;p53阳性组生存率高于阴性 组;④多因素Cox回归分析显示,nm23、C erbB 2不同表达及TNM分期3项指标反映乳腺癌预后情况,危险度 分别为0.395、2.009及1.446。【结论】nm23、C erbB 2表达和TNM分期是乳腺癌的独立的预后指标,检测 nm23、C erbB 2有助于筛选出具有高复发及转移危险的患者。ObjectiveTo explore the protein expression of nm23,C-erbB-2 and p53 genes (3 oncogenes) in breast cancer(BC) tissues and its relation to the clinico-pathological parameters and prognosis.Expressions of nm23 , C-erbB-2 and p53 in paraffin-fixed tissue sections collected from 157 patients with BC were detected by S-P immunohistochemical staining, Kaplan-Meier method and multivariable Cox proportional hazard model were used to analyze the relationship between expressions of these 3 proteins and patient prognosis.①The expression rate of nm23 protein was 58.0%,relating with tumor size,grade of tumor, node metastasis (TNM),the status of involved axillary lymph nodes and distant metastasis;the expression rate of C-erbB-2 protein was 40.8%,it was correlated to patient age,menstruation ,tumor size,TNM ,and status of involved axillary lymph nodes ; whereas rate of p53 protein was 42.7%. its positive expression was associated with TNM, the status of axillary lymph nodes and distant metastasis. ②The positive expression of nm23 was negatively correlated with that of C-erbB-2 protein and positively correlated with that of p53 protein;the positive expression of C-erbB-2 was negatively correlated to that of p53 protein. ③Survival analysis with Kaplan-Meier method showed that the survival rate of patients in nm23 positive group was higher than that in nm23 negative group; but the survival rate of patients in C-erbB-2 positive group was lower than that in C-erbB-2 negative group; while the survival rate of patients in p53 positive group was higher than that in p53 negative group. ④Multivariable Cox regression analysis revealed that the expression of nm23 / C-erbB-2 and TNM were three important and independent prognostic factors for BC ; the hazard ratios of nm23,C-erbB-2 expression and TNM were 0.395,2.009, and 1.446 , respectively.[Conclusion]The expression of nm23/C-erbB-2 and TNM serve as independent prognostic indices of BC. Detection of nm23 and C-erbB-2 would be helpful in screening the highly recurrent ca

关 键 词：乳腺肿瘤/病理学 肿瘤蛋白质类 蛋白质P53 基因 ERBB-2 预后 

分 类 号：R737.9[医药卫生—肿瘤]