HER2阳性乳腺癌组织胰岛素样生长因子-Ⅱ受体的表达与预后的关系  

Relation between expression of IGF-ⅡR in HER2 positive breast cancer and its significance for prognosis

作　　者：陆翔[1] 陈彩萍[1] 邬万新[1] 张燕萍[1] 

机构地区：[1]嘉兴市第一医院乳腺病科,浙江314000

出　　处：《中华内分泌外科杂志》2013年第5期379-383,共5页Chinese Journal of Endocrine Surgery

基　　金：嘉兴市科技计划项目（2010AY1031）

摘　　要：目的 研究胰岛素样生长因子-Ⅱ受体（insulin-like growth factor-Ⅱreceptor,IGF-ⅡR）在人类表皮生长因子受体2（human epidermalgrowth factor receptor 2,HER2）阳性乳腺癌组织中的表达情况及与预后之间的关系.方法 应用免疫组化法测定104例HER2阳性乳腺癌组织中IGF-ⅡR的表达情况,将结果分为阴性和阳性.回顾其年龄、病理学类型、肿瘤大小、淋巴结状态、雌激素受体（estrogen receptor,ER）和孕激素受体（progesterone receptor,PR）表达情况,统计分析IGF-ⅡR表达与上述指标间的关系.并研究IGF-ⅡR表达与患者无病生存率、总生存率之间的关系.结果 IGF-ⅡR阳性率为43.3％ （45/104）.腋窝淋巴结阳性组的IGF-ⅡR阳性率明显高于腋窝淋巴结阴性组（61.5％ vs 25.0％,P=0.000）.IGF-ⅡR阳性率与年龄、病理学类型、肿瘤大小、ER、PR无关.IGF-ⅡR阳性组的无病生存率、总生存率均明显低于IGF-ⅡR阴性组（5年无病生存率：62.6％ vs 84.7％,P=0.022；5年总生存率：71.5％ vs89.6％,P=0.024）.Cox多因素分析提示淋巴结状态是无病生存率和总生存率的独立预测因素,而IGF-ⅡR不是.结论 HER2阳性乳腺癌组织中存在IGF-ⅡR阳性表达,预示着预后更差.IGF-ⅡR的表达可能受胰岛素样生长因子Ⅱ（insulin-like growth factor-Ⅱ,IGF-Ⅱ）调节.Objective To study the expression of insulin-like growth factor-Ⅱ receptor（IGF-Ⅱ R） and its relationship with the prognosis of human epidermalgrowth factor receptor 2 （HER2） positive breast cancer.Methods The expression of IGF-Ⅱ R in 104 specimens of HER2 positive breast cancer was evaluated by immunohistochemistry.The expression was rated on 2 scales：negative and positive.The age,pathological type,tumor size,lymph node involvement,status of estrogen receptor（ER）,and progesterone receptor（PR） of all the cases were reviewed.The relationship between the expression of IGF-Ⅱ R and the above pathological parameters were analyzed by statistical methods.The relationship between the expression of IGF-Ⅱ R and the disease-free survival and overall survival was studied.Results The positive expression rate of IGF-Ⅱ R was 43.3％ （45/104）.The positive rate of IGF-Ⅱ R was significantly higher in the lymph node positive group than in the lymph node negative group （61.5 ％ vs 25.0％,P =0.000）.No significant correlation was observed between the expression of IGF-Ⅱ R and age,pathological type,tumor size,status of ER,or PR.The disease-free survival and overall survival was significantly lower in IGF-Ⅱ R positive group than in IGF-Ⅱ R negative group.（The 5-year disease-free survival：62.6％ vs 84.7％,P =0.022; The 5-year overall survival：71.5％ vs 89.6％,P =0.024）.Cox regressive analysis showed that the lymph node status was an independent risk factor of disease-free survival and overall survival,while the IGF-Ⅱ R was not.Conclusion The positive expression of IGF-Ⅱ R in HER2 positive breast cancer indicates poor prognosis.The expression of IGF-Ⅱ R may be regulated by insulin-like growth factor-Ⅱ （IGF-Ⅱ）.

关 键 词：乳腺癌 胰岛素样生长因子-Ⅱ受体 人类表皮生长因子受体2 免疫组织化学 预后 

分 类 号：R737.9[医药卫生—肿瘤]