乳腺癌分子生物学特性检测的临床意义  

Flow cytometry-pathology combined study of breast cancer

作　　者：于志勇[1] 于金明[2] 吴泰璜[3] 卓培英[1] 王圣芳[1] 李美[1] 张霞[1] 吕宝玉[1] 刘雁冰[1] 

机构地区：[1]山东省肿瘤医院乳腺病中心,济南250117 [2]山东省肿瘤医院放射治疗科,济南250117 [3]山东省立医院普外科

出　　处：《中华肿瘤杂志》2005年第7期420-422,共3页Chinese Journal of Oncology

摘　　要：目的探讨乳腺癌细胞增殖活性、bcl2和突变型p53蛋白表达水平的临床意义。方法应用流式细胞术检测121例乳腺癌的DNA倍体、S期细胞百分比(SPF)及bcl2和突变型p53表达阳性率,结合雌激素受体测定和66例乳腺浸润性导管癌的组织学分级进行统计学分析。结果66例乳腺浸润性导管癌组织Ⅰ、Ⅱ、Ⅲ级间异倍体阳性率、DNA指数(DI)差异均有统计学意义(P均<0.01)。乳腺癌组织Ⅰ、Ⅱ、Ⅲ级的SPF分别为(1.84±1.02)%、(2.44±1.07)%和(2.71±1.16)%,差异有统计学意义(P<0.05);突变型p53表达阳性率分别为(1.03±1.11)%、(2.91±1.61)%和(3.37±2.13)%,差异有统计学意义(P<0.05);bcl2阳性表达率差异无统计学意义(P>0.05),但癌组织与正常组织间差异有统计学意义。雌激素受体阳性与阴性两组间,SPF分别为(2.17±1.04)%和(4.56±1.77)%,突变型p53蛋白表达阳性率分别为(2.93±1.63)%和(4.39±2.73)%,差异均有统计学意义(P<0.05),而bcl2表达阳性率差异无统计学意义(P>0.05)。DI、SPF和p53表达阳性率两两相关,DI与SPF、DI与p53表达阳性率、SPF与p53表达阳性率的相关系数分别为0.73,0.40和0.42(P均<0.01);bcl2表达阳性率与各指标之间无相关关系。结论突变型p53和bcl2与乳腺癌的发生有一定关系;异倍体率、DI与突变型p53表达阳性率可以提示肿瘤预后;流式细胞术检测可以作为病理诊断的补充;乳腺癌患者可术前通过流式细胞术检测提示预后,确立治疗模式。Objective To study the relation between histopathologic grading and some of the cytogenetic and molecular biology characteristics of breast caener. Methods On the basis of estrogen receptor （ER） expression, DNA content, S-phase fraction （SPF）, bel-2 and mutant p53 protein （mtp53） expression were examined by FCM in 121 breast cancer patients. In 66 patients with invasive duetal breast cancer, histopathologic grading was also examined. Results The aneuploidy rate and DNA index （DI） were significantly different in grade Ⅰ, Ⅱ and Ⅲ breast cancer, SPF and mtp53 expression significantly increased with increase in histopathologic grading （ P 〈 0.05）, but bel-2 did not show this trend. SPF and mtp53 expression were significantly more in breast cancer with negative ER than in those with positive ER （ P 〈 0.05）. Again, no such differences in bel-2 regardless of ER expression. Correlations existed between DI vs SPF, DI vs mtp53, and SPF vs mtp53 expressions （ P 〈 0. 01 ） but bcl-2 did not correlate with any one of them. Conclusion Cytogenetic and molecular biology studies on the basis of histopathologic grading may provide more information in prognostic prediction of breast cancer.

关 键 词：乳腺癌 分子生物学 检测 癌组织 

分 类 号：R737.9[医药卫生—肿瘤]