组织蛋白酶D在乳腺导管内癌及伴早期浸润中的表达及其与复发转移的关系  

The expression of cathepsin D in breast ductal carcinoma in situ and with early invasion

作　　者：乌拉木[1,2] 余科达[1] 沈镇宙[1] 邵志敏[1] 

机构地区：[1]复旦大学附属肿瘤医院乳腺外科,复旦大学上海医学院肿瘤学系,上海200032 [2]新疆哈密地区中心医院肿瘤科,新疆哈密839000

出　　处：《中国癌症杂志》2010年第4期247-250,共4页China Oncology

基　　金：国家基础研究计划973项目(2006CB910501);国家自然科学基金(30572109);上海市科委重大项目(06DJ14004;06DZ19504)

摘　　要：背景与目的:组织蛋白酶D(Cath-D)具有促进浸润性乳腺癌增殖转移的作用,但其表达对导管原位癌肿瘤生物学的影响尚不清楚。本研究旨在明确Cath-D在乳腺导管内癌及伴早期浸润中的表达及其与传统临床病理指标的关系,并探讨Cath-D在乳腺导管内癌及乳腺导管内癌伴早期浸润中的表达与复发转移的关系。方法:回顾性分析了复旦大学附属肿瘤医院乳腺医疗中心乳腺癌数据库中的1995年1月—2006年12月期间由该院乳腺外科手术且经病理确诊、资料完整的336例乳腺导管内癌及乳腺导管内癌伴早期浸润的病例。结果:在全部336例患者中Cath-D的表达阳性者241例(71.70%),阴性者95例(28.3%),其中导管内癌143例,Cath-D表达阳性者99例(69.2%),阴性者44例(30.8%),导管内癌伴早期浸润193例,Cath-D阳性表达者142例(73.6%),阴性者51例(26.4%)。Cath-D阳性的患者中有淋巴结转移的有10例(4.15%),Cath-D阴性的患者中有淋巴结转移的有4例(1.66%)。Cath-D的表达与PR、Her-2的表达没有相关性,与ER存在一定相关性(P=0.075),且与突变型p53显著相关(P=0.001)。未复发转移的患者Cath-D阳性表达率约71.5%,而复发转移的病例中阳性率高达80%。结论:Cath-D的阳性表达虽然与浸润性乳腺癌的浸润及转移有关,但其在乳腺导管内癌及乳腺导管内癌伴浸润中的阳性表达与传统临床病理指标的关系无统计学意义。Cath-D的表达在一定程度上能反映乳腺导管内癌及乳腺导管内癌伴早期浸润的预后情况,但其价值似乎并不大。Background and purpose：Cathepsin D（Cath-D） is involved in the proliferation and metastasis of invasive breast cancer.However, its influence on the development of carcinoma in situ is not yet known.This study assessed the expression of protease cathepsin D（Cath-D） in breast ductal carcinoma in situ（DCIS） and early invasion（DCIS-EI） as well as investigated its relationship with known clinicopathologic prognostic factors and breast cancer recurrence.Methods：From Jan.1995 to Dec.2006, a total of 336 patients with DCIS and DCIS-MI that treated surgically were retrospectively studied.Results：The positive rate of Cath-D expression was 71.70% in all cases, 69.2% in DCIS and 73.6% in DCIS-EI.Lymph nodes metastases were observed in 4.15% of all cases in the Cath-D positive group and in 1.66% of all cases in the Cath-D negative group.The expression of Cath-D were closely correlated with mutant p53（P=0.001）, slightly correlated with ER expression（P=0.075）, and had no significant relationship with PR or Her-2 expression.The expression rate of Cath-D increased in recurrence groups（80%） in comparison with nonrecurrence groups（71.5%）.Conclusion：In contrast to the expression of Cath D in invasive breast cancer tissues, Cath D in DCIS and DCIS-EI are not found to be associated with known clinicopathologic prognostic factors.Cath-D may be a prognostic marker for DCIS and DCIS-EI but nevertheless, it is not very distinctive.

关 键 词：组织蛋白酶D 乳腺导管内癌 早期浸润 临床生物学指标 

分 类 号：R73-362[医药卫生—肿瘤]