雌激素受体阳性乳腺癌组织PIMT蛋白表达临床意义探讨  

Expression of PIMT and its clinicopathological and prognostic significance in ER-positive breast cancer

作　　者：洪超群[1] 张凡[1] 吴晓[2] 庄轶轩[1] 陈熹鹏 崔玉坤[1] 

机构地区：[1]汕头大学医学院附属肿瘤医院广东省乳腺癌诊治研究重点实验室,广东汕头515041 [2]汕头大学医学院附属肿瘤医院中心实验室,广东汕头515041

出　　处：《中华肿瘤防治杂志》2015年第13期1014-1018,共5页Chinese Journal of Cancer Prevention and Treatment

基　　金：广东省自然科学基金面上项目(S2013010015969);广东省医学科研基金(B2012261);汕头市医疗重点科技计划(汕府科[2012]113号);汕头大学医学院附属肿瘤医院内青年基金(汕大医肿瘤医[2014]10)

摘　　要：目的分析雌激素受体（estrogenreceptor，ER）阳性乳腺癌组织PIMT蛋白的表达及其与临床病理指标和预后的关系。方法收集汕头大学医学院附属肿瘤医院2001—10—16—2002—12—30接受治疗的女性乳腺癌患者117例，ER表达均为阳性。利用免疫组织化学技术检测乳腺癌标本中PIMT蛋白的表达，采用Y。检验分析其与临床病理特征的关系，采用z检验、Kaplan—Meier法和Cox回归模型分析PIMT蛋白表达对预后的影响。结果PIMT蛋白主要定位在细胞质，117例ER阳性乳腺癌组织PIMT蛋白的高表达率为36．8％（43／117），其表达与患者的年龄（X2^=0．444，P=0．505）、肿瘤大小（X2^=0．545，P=0．461）、淋巴结转移（X2^=0．005，P=0．942）、临床分期（X2^=0．073，P=0．787）、PR（X2^=1．483，P=0．223）和HER-2（X2^=0．780，P=0．377）表达均无关；与随访结局有关，X2^=4．194，P=0．041；PIMT低表达和高表达的患者10年的生存率分别为51．8％和79．4％，差异有统计学意义，X2^=-3．229，P=0．001；两组总体生存曲线差异有统计学意义，X2^=3．999，Log—RankP=0．046。Cox回归分析提示，临床分期（HR：8．526，95％CI：2．568～28．300，Wald X2^=12．257，P〈0．001）和PIMT是ER阳性乳腺癌患者独立的预后因素（HR：0．403，95％CI：0．172～0．945，Wald X2^=4．371，P=0．037）。结论PIMT在乳腺癌进展中发挥重要作用，可作为临床上ER阳性乳腺癌一个新的预后指标，可能与内分泌治疗耐药有关。OBJECTIVE To study the PIMT protein expression and its relationship with clinicopathological param- eters, and its influence on the prognosis of human ER-positive breast cancer. METHODS We collected tumor tissues from 117 female patients with ER-positive breast cancer treated at the Cancer Hospital of Shantou University Medical Col- lege from October 2001 to November 2002. Immunohistochemistry was performed to detect the protein expression of PIMT in breast tumors, and ehi-square test was used to study the relationship between the PIMT expression and clinico pathological parameters. The z test, Kaplan-Meier method and Cox regression model were conducted to study the influ- ence of PIMT on the prognosis of ER-positive breast cancer. RESULTS PIMT protein was expressed primarily in the cytoplasm. The high expression rate of PIMT in 117 ER-positive breast tumors was 36.8 % （43/117）, and the PIMT ex- pression was correlated to survival（x2 =4. 194,P=0. 041） ,but not age （X2^ =0. 444, P=0. 505）, tumor size （X2^ =0. 545, P=0. 461）, Lymph node metastasis （X2^ =0. 005, P=0. 942）, clinical stages （X2^ =0. 073, P=0. 787）, PR （X2 =1. 483, P= 0. 223） and HER-2 expression （Xe = 0. 780, P=0. 377）. The overall 10-years survival rates were significantly differ- ent between the low PIMT expression group and the high PIMT expression group （51.8% vs 79.4%, z= -3. 229,P=0. 001）, and the survival curves in these two groups were significantly different （2 = 3. 999, Log Rank P= 0. 046）. Cox regression model demonstrated that clinical stages （HR： 8. 526,95 ;CI： 2. 568- 28. 300 ,Wald 3（2 = I2. 257, P〈0. 001） and PIMT （HR ： 0. 403,95 % CI ： 0. 172- 0. 945, Wald ：（z = 4. 371, P = 0. 037） were the independent prognostic factors for ER-positive breast cancer. CONCLUSION PIMT plays an important role in the progression of breast cancer and could he a novel prognostic factor for ER-positive breast cancer, which probably relates to the anti-estrogen therapies.

关 键 词：乳腺肿瘤 PCMT 免疫组织化学 预后 内分泌治疗 

分 类 号：R737.9[医药卫生—肿瘤]