p-mTOR在Luminal型乳腺癌中的表达情况及预后  

Expression and prognostic of p-mTOR in luminal breast cancer

作　　者：王洁[1] 朱信信[2] 沈贵华[1] 刘秀云[1] 袁燕玲[1] 王冰凝[1] 杨红鹰[1] 

机构地区：[1]国家癌症中心/中国医学科学院北京协和医学院肿瘤医院病理科,北京100021 [2]北京协和医学院北京协和医院妇产科,北京100730

出　　处：《中国肿瘤临床与康复》2017年第3期270-275,共6页Chinese Journal of Clinical Oncology and Rehabilitation

摘　　要：目的探讨p-mTOR在Luminal A型与Luminal B型乳腺癌中表达情况的差异,并全面系统分析该蛋白表达与临床病理特征的关系及对预后的影响。方法选取1999年1月至2008年12月间于北京协和医学院中国医学科学院肿瘤医院行乳腺癌根治术切除的211例有完整病理及生存资料的乳腺癌患者。采用组织芯片技术和免疫组化染色方法,检测p-mTOR在75例Luminal A型乳腺癌患者和136例Luminal B型乳腺癌患者中的表达情况及其与临床病理特征和预后的关系。结果在Luminal A亚型乳腺癌中,p-mTOR表达阳性患者总共38例(50.7%),其中p-mTOR胞浆着色结果与临床分期差异有统计学意义(P=0.04);p-mTOR细胞核或核周着色结果与年龄差异有统计学意义(P=0.03)。Kaplan-Meier生存分析显示p-mTOR总体阳性表达患者的无病生存时间更长,差异有统计学意义(P=0.01)。在Luminal B亚型中p-mTOR阳性表达患者共89例(65.4%)。细胞核或核周着色结果与肿瘤直径和临床分期间差异均有统计学意义(均P<0.05),Kaplan-Meier生存分析显示核或核周着色阳性患者的无病生存时间低于阴性表达者,差异有统计学意义(P<0.01),经Cox多因素分析进一步证实核或核周着色结果是乳腺癌复发转移的独立预后因素(P=0.01,HR=0.182,95%CI 0.060~0.550)。结论 p-mTOR在乳腺癌不同亚型患者中的多样化表达特点提示不同的疾病行为及预后意义。p-mTOR作为Luminal B型乳腺癌的独立预后因素,是潜在的有效靶点。Objective To explore the difference of p-mTOR expression level in luminal A and luminal B breast cancer,and comprehensively and systematically analyze the correlations of the protein expression with clinical pathological features as well as prognosis. Methods Two hundred and eleven patients with complete pathological and survival data and who received radical mastectomy at Cancer Hospital,Chinese Academy of Medical Sciences,Peking Union Medical College were selected between January 1999 to December 2008. Tissue microarray and immunohistochemistry staining method were used to assess p-mTOR expression features in 75 luminal A patients and 136 luminal B patients and the association with pathological characteristics and outcomes. Results p-mTOR was positive in a total of 38 patients（ 50. 7%） for the luminal A subtype and cytoplasmic p-mTOR was correlated with clinical stage（ P = 0. 04）. Cytoplasmic pmTOR in the nucleus and perinuclear area was correlated with different ages（ P = 0. 03）. Kaplan-Meier analysis revealed that patients with positive p-mTOR expression had longer disease-free survival time（ P =0. 01）. In luminal B subtype,89 patients（ 65. 4%） were found to have positive p-mTOR. Kaplan-Meier analysis revealed that there was significant difference in staining in the nuclear or perinuclear region,tumor diameter and clinical stage between the two groups（ all P〈 0. 05）. Patients with positive expression in the nuclear or perinuclear area tended to have an shorter disease-free surviva than patients with negativel expression（ P〈 0. 05）. It was further demonstrated in a multivariable Cox analysis that staining results in the nuclear or perinuclear region staining was an independent predictor for recurrence and metastasis of brest cancer（ P = 0. 01,HR = 0. 0182,95% CI 0. 060-0. 550）. Conclusion The variable staining patterns of pmTOR in different subtypes of breast cancer indicat different disease behaviors and prognosis. As an independent prognostic factor for luminal B subtype,p

关 键 词：P-MTOR 乳腺肿瘤 免疫组化 预后 

分 类 号：R737.9[医药卫生—肿瘤]