p53、c-erbB-2和组织蛋白酶D与腋窝淋巴结阴性乳腺癌患者预后的关系  

Overexpression of p53,c-erbB-2 and cathepsin D in patients with node negative breast carcinoma and prognosis

作　　者：王淑莲[1] 张伟[1] 余子豪[1] 王洪平[1] 金玉生[1] 刘易 曲平[1] 李茉[1] 

机构地区：[1]中国医学科学院肿瘤医院肿瘤研究所,北京100021

出　　处：《中华外科杂志》2001年第2期128-131,共4页Chinese Journal of Surgery

基　　金：中国医学科学院基金;中国协和医科大学院校长CMB基金资助

摘　　要：目的　探讨p5 3、c erbB 2和组织蛋白酶D(cathepsinD)在评估腋窝淋巴结阴性乳腺癌(NNBC)患者预后中的价值。　方法　用免疫组化方法 ,检测 110例T1 2 N0 M0 期乳腺癌患者原发灶癌组织中p5 3、c erbB 2和cathepsinD水平 ;并用单因素和多因素统计方法对其结果与肿瘤的临床特性及患者预后之间的关系进行了分析。　结果　本组肿瘤直径 >3cm的患者比 <3cm患者的远处转移率高 ,无瘤生存率和总生存率下降 ,差异有显著性意义 (分别P <0 0 5、P <0 0 1、P <0 0 5 ) ;cathepsin阴性患者的肿瘤远处转移率、无瘤生存率、分别为 8 2 5 %、82 6 1% ,阳性患者为 33 0 6 %、5 7 41% ,差异均有极显著性意义 (P <0 0 1) ;c erbB 2阴性患者及p5 3表达状态与患者的肿瘤远处转移率、无瘤生存率和总生存率无关。 6 2例未作全身治疗的患者 ,cathepsin阴性患者的肿瘤远处转移率、无瘤生存率、分别为 8 92 %、77 0 4% ,阳性患者为 44 6 1%、43 46 % ,差异均有极显著性意义 (P <0 0 1) ;c erbB 2阴性患者的肿瘤远处转移率、无瘤生存率、和总生存率分别为 16 70 %、70 11 %、88 30 % ;阳性患者为41 2 6 %、44 44 %、6 8 6 5 % ,差异均有显著性意义 (P <0 0 5 ) ;5 3表达状态与患者的肿瘤远处转移率、无瘤生存率和总生存?Objective To determine the prognostic value of p53,c erbB 2 and cathepsin D overexpression in patients with node negative breast carcinoma (NNBC). Methods Expression of p53, c erbB 2 and cathepsin D was measured immunohistochemically in primary tumors of 110 node negative breast cancer patients with T1 2. Data were analyzed by both univariate and multivariate statistical analysis to find out their relation to local, regional recurrence, distant metastasis, relapse free survival (RFS) and overall survival (OS) rates. ResultsUnivariate analysis showed that tumor size is an important clinical prognostic factor related to distant metastasis, RFS, and OS. Overexpression of c erbB 2 and cathepsin D were significantly associated with both distant metastasis and RFS by univariate analysis. In multivariate analysis, tumor size and cathepsin D were significant and independent factors for distant metastasis and RFS, and tumor size was independently associated with OS. P53 expression was not associated with prognosis as shown by either univariate or multivariate analysis. ConclusionTumor size and cathepsin D are independent prognostic indicators of failure, which are useful in selection of high risk NNBC patients for adjuvant therapies.

关 键 词：乳腺肿瘤 预后 P53基因 C-ERBB-2蛋白 组织蛋白 

分 类 号：R737.9[医药卫生—肿瘤]