乳腺浸润性导管癌患者中FHIT、Bcl-2、Bax的表达及其临床病理意义  

Expression of the genes FHIT, Bcl-2 and Bax in breast infiltrating ductal carcinoma and clinicopathological significance thereof

作　　者：王湛博[1] 赵坡[1] 刘梅[1] 李向红[1] 

机构地区：[1]解放军总医院病理科,北京100853

出　　处：《中华医学杂志》2006年第31期2171-2176,共6页National Medical Journal of China

基　　金：首都医学发展基金资助项目(2002-3039)

摘　　要：目的探寻生物标志物FHIT、Bcl-2、Bax对术后化疗的选择及化疗患者预后的提示作用。方法用HE及SP免疫组化染色法对100例乳腺浸润性导管癌作回顾性分析。研究生物标志物在乳腺浸润性导管癌的表达与肿瘤生物学特点及患者无瘤生存时间和总体生存时间的关系。结果各生物标志物的阳性率分别为FHIT 73％,Bcl-2 50％,Bax 34％,其中FHIT和Bcl-2的表达正相关(r=0．3290),FHIT和Bcl-2的表达与组织学分级负相关,分级越高,表达越低。FHIT和Bcl-2的阳性表达的患者无瘤生存时间和总体生存时间均长于阴性者。FHIT为阳性表达者,化疗后平均无瘤生存时间(56．8个月)长于FHIT阴性者(35．8个月),Bcl-2为阳性表达者,化疗后平均无瘤生存时间(54．8个月)长于Bcl-2阴性者(41．6个月),Bcl-2为阴性时,单独使用CAF的患者平均无瘤生存时间55个月和总体生存时间58．8个月均长于使用其他化疗方案的患者,其无瘤生存时间和总体生存时间分别为27个月和36个月。Bax表达与患者的预后无关。结论FHIT和Bcl-2的表达与患者的无瘤生存时间和总体生存时间相关。FHIT为阳性表达,患者化疗后无瘤生存时间较长,复发率较低。患者的Bcl-2为阴性时,单独使用CAF组比使用其他化疗方案组的患者的无瘤生存时间和总体生存时间更长,预后更好。Objective To investigate the expression of the genes fragile histidine triad （ FHIT）, Bcl-2, and Bax, biological markers of breast infiltrating ductal carcinoma in this carcinoma and clinicopathological significance thereof. Methods The clinical data of 100 patients with breast infiltrating ductal carcinoma, all females, aged 435 （ 28 - 92）, were collected. Immunohistochemistry was used to detect the protein expression of FHIT, Bcl-2 and Bax in the carcinoma tissues rsected during operation. Results The protein expression rates of FHIT, Bcl-2 and Bax in the tumor tissues were 73%, 50%, and 34% respectively. The disease free survival （DFS） and overall survival （OS） of the FHIT positive patients were 81.8 months and 123.6 months, both significantly longer than those of the FHIT-negative patients （27.7 months and 74 months, both P 〈 0. 05 ）. The DFS of the Bcl-2-positive patients was 83 months, significantly longer than that of the Bcl-2-negtive patients （45 months, P 〈 0. 05 ）. The mean DFS of the Bcl-2-positive patients who received postoperative adjuvant chemotherapy was 54. 8 months, significantly longer than that of the Bcl-2-negative patients who received postoperative adjuvant chemotherapy （41.6 months）. The mean DFS and OS of the Bcl-2-negative patients receiving CAF regimen were 55 months and 58. 8 months respectively, both longer than those of the Bcl-2-negative patients receiving other regimens （27 months and 36 months respectively）. However, the expression of Bax failed to show correlation with the prognosis of breast infiltrating ductal carcinoma. Conclusion Expression of FHIT and expression of Bcl-2 are positively correlated to the DFS and OS of the breast infiltrating ductal carcinoma. Bax is not predictive to the prognosis of breast infiltrating ductal carcinoma.

关 键 词：乳腺肿瘤 免疫组织化学 癌 浸润性导管 生物学标志物 

分 类 号：R737.9[医药卫生—肿瘤] R735.2[医药卫生—临床医学]