多基因的蛋白表达联合判断早期乳腺癌预后的COX模型分析  

Protein expressions of multi-gene for predicting the prognosis of early breast cancer with COX model analysis

作　　者：覃宇周[1] 刘剑仑[1] 欧海玲[2] 祝晓强[1] 胡德宏[3] 

机构地区：[1]广西医科大学肿瘤医院胃肠乳腺科,广西南宁530021 [2]广西中医学院第一附属医院院病理科,广西南宁530023 [3]广西壮族自治区人民医院,广西南宁530021

出　　处：《中国癌症杂志》2009年第2期125-128,共4页China Oncology

基　　金：广西壮族自治区卫生厅重点科研课题(No:重200313)资助

摘　　要：背景与目的:临床上,单纯的临床病理特征尚不能准确判断早期乳腺癌患者的预后。在目前公开发行的刊物及基因组数据库中,可能与乳腺癌发生发展、复发转移以及预后有关的基因达200多个。我们通过筛选检测16个基因的蛋白表达情况,探讨在分子水平上预测早期乳腺癌患者预后的可行性。方法:采用免疫组织化学二步法检测76例早期乳腺癌患者16个基因(Her-2、ER、PR、BCL2、Ki-67、BMYB、CyclinB1、STK15、MMP11、BAG1、NM23、PTEN、P53、P27、VEGF、PCNA)的蛋白表达情况,并应用COX风险比例模型进行统计分析。结果:经COX风险比例模型多因素分析发现,影响早期乳腺癌预后的基因为:BCL2、VEGF、STK15。根据这三个基因建立预后指数(PI)计算公式,将此公式运用于48例早期乳腺癌患者,其预测结果与实际的随访结果相比较,预测预后好、差的准确率分别是86.67%、91.67%。结论:根据16个乳腺癌相关基因的蛋白表达最终建立的PI计算公式可用于判断早期乳腺癌患者的预后。Background and purpose： The prognosis in patients with early breast cancer（EBC） was poorly defined by clinical and histopathological features. There were more than 200 genes that might be correlated with development, progression, recurrence and prognosis of breast cancer in the published literature. This study evaluated the prognosis of patients with EBC at molecule level according to the protein expressions of 16 selecting genes （HER2,ER,PR,BCL2,Ki-67,BMYB,Cyclin B 1 ,STK15,MMP 11 ,BAG 1 ,NM23,PTEN,P53,P27,VEGF, PCN A）. Methods： The immunohistochemical method was used to detect the protein expressions of these genes in 76 patients with EBC and the statistical analysis was performed by COX proportional hazards model. Results： COX proportional hazard model revealed that BCL2, VEGF and STK15 were independent prognostic factors for patients with EBC. A formula of PI was set up according the three genes. The predictive outcomes with PI were compared with the actual follow-up outcomes in 48 patients with EBC. As a result, the predictive accuracy of good and bad prognosis was 86.67% and 91.67%, respectively. Conclusion： A formula of PI derived from protein expressions of the 16 genes correlated with breast cancer was ultimately set up and might be used to predict the outcomes of the patients with EBC.

关 键 词：早期乳腺癌 基因 预后 COX风险比例模型 

分 类 号：R730.7[医药卫生—肿瘤]