三阴乳腺癌组织中乳腺小黏蛋白和局部黏着斑激酶的表达及意义  

Correlation and Clinical Significance of Small Breast Epithelial Mucin and Focal Adhesion Kinase in Triple-negative Breast Cancer

作　　者：张微[1] 张尘玉 杨志强[1] 迟新楠 岳莉[1] 

机构地区：[1]辽宁医学院,辽宁省锦州市121001

出　　处：《中国全科医学》2014年第6期632-636,共5页Chinese General Practice

摘　　要：目的检测乳腺小黏蛋白(SBEM)及局部黏着斑激酶(FAK)在三阴乳腺癌(TNBC)组织中的表达情况,并探讨两者的相关性及临床意义。方法收集2005—2007年辽宁医学院附属第一医院术后诊断为乳腺癌的石蜡标本67例,采用免疫组化法检测SBEM和FAK在TNBC组织中的表达情况,两者相关性分析采用列联表独立性χ2检验,生存分析采用Kaplan-Meier生存曲线,预后因素采用Cox风险比例模型进行多因素分析。结果 SBEM在TNBC中阳性率为52.2%(35/67),FAK在TNBC中阳性率为68.7%(46/67)。不同病理分级、淋巴结转移和Ki67表达情况的TNBC患者癌组织中SBEM和FAK阳性率比较,差异均有统计学意义(P<0.05),而不同月经状况、年龄、肿块直径的TNBC患者癌组织中SBEM和FAK阳性率比较,差异均无统计学意义(P>0.05)。SBEM与FAK之间有关联,Pearson列联系数r=0.438。SBEM阳性组中位无病生存期(DFS)为21.4个月,中位总生存期(OS)为28.9个月;SBEM阴性组中位DFS为23.3个月,中位OS为35.6个月,两组比较差异均有统计学意义(P<0.05)。FAK阳性组中位DFS为20.7个月,中位OS为25.4个月;FAK阴性组中位DFS为22.9个月,中位OS为32.5个月,两组比较差异均有统计学意义(P<0.05)。67例TNBC患者5年无瘤生存率为7.5%,5年总生存率为13.4%。采用Cox模型进行多因素分析,结果显示,病理分级、淋巴结转移、Ki67、SBEM和FAK与5年无瘤生存率和5年总生存率有回归关系(P<0.05)。结论 SBEM和FAK可能在乳腺癌的发生和发展过程中起着重要的调节作用,是TNBC不良预后的影响因素,且两者在TNBC中的表达呈正相关,联合检测两者的表达可能为乳腺癌的转移和预后判断提供一定的参考。Objective To detect the expression of small breast epithelial mucin （SBEM） and focal adhesion kinase （FAK） in triple -negative breast cancer （TNBC） tissues, and to explore the correlation between the two and their clinical sig- nificances. Methods Paraffin specimens of 67 cases diagnosed as breast cancer from 2005 to 2007 in the First Affiliated Hospital of Liaoning Medical University were collected. Immunohistochemical staining was used to detect the expression of SBEM and FAK in TNBC tissues. Contingency tables independence X2 test was used to analyze the correlation between the two, Kaplan - Meier survival analysis was used to conduct survival analysis and Cox proportional hazards model was used to conduct multivariate analy- sis for prognostic factors. Results The positive rate of SBEM and FAK was 52. 2% （35/67） and 68. 7% （46/67） respectively in TNBC. Histological grade, lymph node metastasis and Ki67 were correlated with the positive expression of SBEM and FAK in TNBC （P 〈 O. 05）, while menstrual status, age and tumor diameter were not correlated with their positive expression （P 〉 0. 05） . SBEM was correlated with FAK, with a contingency coefficient of 0. 438. The disease - free survival （DFS） of the SBEM positive group was 21.4 months, and the overall survival （OS） was 28.9 months. The DFS of the SBEM negative group was 23.3 months, and the OS was 35.6 months. The difference was statistically significant （ P 〈 0. 05 ） . The DFS and OS in the FAK positive group were 20. 7 months and 25.4 months respectively, and the DFS and OS in the FAK negative group were 22. 9 moths and 32. 5 months respectively, showing statistically significant difference （P 〈 0. 05） . The 5 - year DFS of the 67 TNBCpatients was 7.5%, and the 5 -year OS was 13.4%. Multivariate analysis by Cox model showed that histological grade, lymph node metastasis, Ki67, SBEM and FAK were independent prognostic factors of 5 - year DFS and 5 - year OS （ P 〈 0. 05 ）. Conclusion SBEM and FAK m

关 键 词：乳腺肿瘤 黏蛋白类 黏着斑激酶 无病生存 

分 类 号：R737.9[医药卫生—肿瘤]