ER、PR以及HER-2在乳腺癌原发灶及复发灶间表达差异及其临床意义  

Discordance of ER,PR and HER-2 receptor statuses between primary and metastatic focuses of breast cancer

作　　者：杜江[1] 董朝[1] 钟红[1] 马斌林[1] 

机构地区：[1]新疆医科大学附属肿瘤医院乳腺头颈外科,乌鲁木齐830011

出　　处：《新疆医科大学学报》2013年第5期653-655,共3页Journal of Xinjiang Medical University

基　　金：乌鲁木齐市科学技术计划项目(Y09231001)

摘　　要：目的探讨复发转移乳腺癌病例原发灶与复发转移灶之间存在的受体差异及其临床意义。方法采用免疫组织化学方法检测45例复发转移乳腺癌病例中雌激素受体(estrogen receptor,ER)、孕激素受体(proges-terone receptor,PR)以及人表皮生长因子受体2(human epidermal growth factor receptor-2,HER-2)在原发灶与复发转移灶之间的表达差异。结果在原发灶中,27例患者ER阳性,阳性率为60.00%,在复发转移灶中16例患者ER阳性,阳性率为35.56%,原发灶中ER阳性率高于复发转移灶ER的阳性率,差异有统计学意义(P<0.05);在45例乳腺癌病例原发病灶中,PR、HER-2阳性分别为23例(51.11%)、9例(20.00%),复发转移病灶中,PR、HER-2阳性分别为21例(46.67%)、10例(22.22%),原发灶与复发转移灶中PR、HER-2表达差异无统计学意义(P>0.05)。在45例乳腺癌病例中,ER由阳性转为阴性者共9例,由阴性转为阳性者2例,总的变化例数为11例,变化率为24.44%;PR由阳性转为阴性者共8例,由阴性性转为阳性者共5例,总的变化数为13例,变化率为28.89%;有4例HER2阴性患者在复发转移灶中过表达,另外有3例患者转化为转移灶的阴性或低表达,总的变化数为7例,变化率为15.56%。结论 ER在乳腺癌原发灶以及转移复发灶之间的表达存在差异,对于乳腺癌复发转移患者制定治疗方案时,应充分考虑到受体变化的影响。Objective To investtigate discordance of estrogen receptor （ER）, progestogen receptor（PR）, and human epidermal growth factor receptor-2 （HER-2） statuses between primary and metastatic focuses of breast cancer. Methods Immunohistochemical staining was used to detect expression of ER, PR, HER- 2 receptor in primary and metastatic focuses of 45 cases of breast cancer. Results Positive rate of ER in primary focuses was 60% （27/45）,significantly higher than that in metastatic focuses （35.56%, 16/45, P d0. 05）. While position rates of PR and HER-2 receptor in primary focuses were 51. 11% （23/45）, 20.00%（9/45）, there was no significant difference between that in metastatic focuses （46.67%, 21/45; 22.22%, 10/45, P〉0. 05）. Total discordance rates of ER, PR and HER-2 were 24. 44%（11/45）, 28.89%（13/45） ,15.56% （7/45）, respectively. Conclusion Difference in expression level of ER between primary and metastatic focuses of breast cancer was significant, while differences of expression of PR and HER-2 was not significant, the expression differences of ER, PR and HER-2 in our clinical practices still should be thought highly.

关 键 词：乳腺癌 雌激素受体(ER) 孕激素受体(PR) 人表皮生长因子受体2(HER-2) 免疫组织化学 

分 类 号：R392.3[医药卫生—免疫学] R655.8[医药卫生—基础医学]