原发性乳腺癌细胞周期及凋亡与其他预后因素间的相关性分析  

Correlation of cell cycle and apoptosis with other prognostic factors in primary breast cancer

作　　者：徐瑞龙[1] 郑昭璟[1] 施红旗[2] 王蓓[3] 

机构地区：[1]金华市中心医院检验科,321000 [2]金华市中心医院病理科,321000 [3]金华市中心医院肿瘤科,321000

出　　处：《浙江医学》2009年第1期14-17,共4页Zhejiang Medical Journal

摘　　要：目的对原发性乳腺癌患者的肿瘤细胞进行细胞周期分析和细胞凋亡状态检测，分析这两个指标与其他预后因素之间的相关性。方法对49例原发性乳腺癌患者采用流式细胞术进行细胞周期分析和细胞凋亡状态的检测，免疫组化染色法进行ER、PR、表皮生长因子受体（EGFR）及c-erbB-2检测。结果49例原发性乳腺癌中，异倍体肿瘤占612％（30／49），ER阳性占51．0％（25／49），PR阳性占53．1％（26／49），EGFR阳性占122％（6／49），c-erbB-2阳性占306％（15／49），出现腋淋巴结转移者占449％（22／49）。原发性乳腺癌细胞凋亡率为（560±1．21）％。高S期细胞比例（SPF）组肿瘤标本增殖指数（P1）明显高于中SPF组，而细胞凋亡率、DNA指数（DI）、G1峰变异系数（G、CV）、G2/M期百分数、患者年龄等因素在不同倍体、不同水平SPF组间未见明显差异。二倍体原发性乳腺癌标本ER阳性率明显高于异倍体标本，而腋淋巴结转移的阳性率则相反。低、中、高SPF组间乳腺癌标本PR、EGFR阳性率的差异有统计学意义。SPF与原发性乳腺癌细胞EGFR的表达及GJM期细胞比例有关；DI与PI有关；细胞凋亡率与PR的表达有关。ER与PR、EGFR与c-erbB-2的表达相关，尤其ER与PR两者间具有极强的正相关关系。结论二倍体和异倍体原发性乳腺癌EGFR表达和腋淋巴结转移发生率是不同的；各水平SPF组间PR、EGFR的表达明显不同；SPF与EGFR的高表达、高凋亡指数与PR的表达具有相关关系。因此，将细胞周期分析和凋亡检测与其他临床常用的乳腺癌诊断指标进行联合应用，将有助于对乳腺癌生物学行为的了解。Objective To investigate the correlation of cell cycle and apoptosis with other prognostic factors in primary breast cancer. Methods The expression of estrogen receptor （ER）, progesterone receptor （PR）, epithelial growth factor receptor （EGFR） and e-erbB-2 on tumor cells were detected with S-P method in 49 cases of primary breast cancer. Cell cycle analysis was performed with DNA Prep kit and Multicycle for Windows software, and cell apoptosis was analyzed by dual-color flow cytometry. Results Aneuploid tumor was identified in 30 of 49 patients with primary breast cancer （61.2%）. The positive rates for ER, PR, EGFR and c-erbB-2 staining were 51.0% （25/49）, 53.1% （26/49）, 12.2% （6/49） and 30.6% （15/49）, respectively. Lymph node metastasis （LNM） was detected in 22 of 49 patients. The rates of low, intermediate and high S-phase fraction （SPF） were 25.0% （12/49）, 32.1% （16/49） and 42.9% （21/49）, respectively. The apoptosis rate of this series was 5.60% （±1.21%）. The proliferation index （PI） of tumor cells in high SPF category was higher than that in intermediate SPF. There were no significant differences in apoptotic rate, DNA index （DI）, G1 CV, percentage of cells at G2/M phase, and age between aneuploid and diploid breast cancer, and among groups with different SPF levels. In contrary to LNM, the positive rate of ER in diploid breast cancer was higher than that in aneuploid breast cancer. A significant difference on the positive rate of PR, EGFR expression was found among groups of low, intermediate, and high SPF. SPF was correlated with EGFR expression and G2/M phase distribution in primary breast cancer. A correlation was also revealed between DI and PI, between apoptotic cell number and PR expression, and there was also a strong correlation between EGFR and c-erbB-2, between ER and PR expression. Conclusion The results suggest that it would be helpful to integrate cell cycle analysis and detection of spontaneous apoptosis into an extended panel of

关 键 词：细胞周期 细胞凋亡 乳腺癌 预后 

分 类 号：R737.9[医药卫生—肿瘤] R733.71[医药卫生—临床医学]