乳腺癌组织中表皮生长因子受体4的表达及其临床病理意义  

Expression of HER-4 in breast cancer and their clinicopathological significance

作　　者：李俊杰[1] 刘仁斌[1] 王佳妮[1] 穆哈迈德[1] 李雯[2] 梁惠珍[3] 张文辉[3] 

机构地区：[1]中山大学附属第三医院乳腺疾病诊治中心,广州510630 [2]中山大学附属第一医院外科实验室 [3]中山大学附属第一医院病理科

出　　处：《中华普通外科学文献（电子版）》2009年第5期10-13,共4页Chinese Archives of General Surgery(Electronic Edition)

基　　金：国家自然科学基金(30672410);广州市科技局国际合作项目(2007Z3-I0021)

摘　　要：目的探讨人表皮生长因子受体4(HER-4)在人类表皮生长因子受体2(HER-2)强阳性㈦阴性乳腺癌组织中的表达差异,分析其㈦雌激素受体α(ERα)、孕激素受体(PR)表达情况及其TNM分期和腋窝淋巴结状况的关系。方法随机选择中山大学附属第一医院在2004年12月至2007年12月收治的HER-2高表达(+++)51例与无表达(-)49例乳腺浸润性导管癌病例,分别检测乳腺癌组织的HER-4、HER-2、ERα、ERβ、ERβ1、ERβcx、PR的表达水平,分析HER-4与以上各指标以及与肿瘤TNM分期、腋窝淋巴结转移等临床指标的相关性。结果HER-4、ERα、ERβ、ERβ1、ERβcx、PR在HER-2(+++)组的阳性表达率分别为43.13%、33.33%、45.10%、47.06%、78.43%、64.71%,在HER-2(-)组中的阳性表达率分别为69.38%、71.42%、81.63%、87.75%、87.75%、79.59%;两组中上述指标的表达差异均有统计学意义(P<0.05或P<0.01)。两组的HER-4表达与ERα、ERβ、PR、ERβ1、ERβcx呈正相关(P<0.05或P<0.01)。细胞膜、细胞质及细胞核表达率在HER-2(+++)组中分别为41.17%、37.25%、3.90%;在HER-2(-)组中分别为69.38%、48.97%、2.05%。两组中HER-4的细胞膜表达率差异有统计学意义(P<0.01),但在细胞质及细胞核的表达率未显示出明显差异。结论HER-4可作为乳腺癌预后良好的指标,在乳腺病理诊断中增加HER-4的检测对治疗和判断预后有一定的指导作用。HER-4在亚细胞中的不同定位值得进一步研究。Objective To explore the difference of the human epidermal growth factor receptor4 （HER-4） in the human epidermal growth factor receptor 2 （HER-2） positive and negative breast carcinoma, and their relationship with estrogen receptor α （ERα ）, progesterone receptor （PR） expression and TNM stage and lymph node metastasis. Methods Fifty one of breast invasive ductal carcinomas with HER-2（＋＋＋） and 49 cases with HER-2（-） were randomly selected from the first affiliated hospital of Sun Yat-sen university from Dec 2004 to Dec 2007, and detected for the expressions of HER-4, ER α, ER 15, ER 15 land ER 15 cx and PR respectively, and then analyzed for their relationship with TNM stage and lymph node metastases. Results The positive rates of HER-4, ER α, ERβ, ERβ1, ERβcx and PR in the HER-2（＋＋＋） patients were 43.13%, 33.33%, 45.10%, 47.06%, 78.43%, 64.71% respectively, and in HER-2 （-） patients were 69.38%, 71.42%, 81.63%, 87.75%, 87.75%, 79.59%, respectively, the differences were statistically significant （P〈0.05 or P〈0.O1）. The expression rates of HER-4 in cell membrane, cytoplasm and nuclear in the HER-2（＋＋＋） patients were 41.17%, 37.25%, 3.9%, respectively in HER-2 （-） patients were 69.38%, 48.97%, 2.05%, respectively. The positive rate of HER-4 in the cell membrane in the HER-2（-） patients was significant higher（P〈0.01） than those in HER-2 （＋＋＋） patients. There was no significant difference between the expression rates of HER-4 in cell cytoplasm, nuclear. Conclusion HER-4 is a good indicator of prognosis of breast cancer, and it is helpful to test the expression of HER-4 for the treatment and estimation of the prognosis. HER-4 in the different sub-cellular location is worthy of further study.

关 键 词：乳腺癌 表皮生长因子受体 雌激素受体Α 孕激素受体 

分 类 号：R737.9[医药卫生—肿瘤]