新标记物GATA3在乳腺癌替代分子分型中表达的敏感性分析  

Sensitivity analysis on the novel marker GATA3 expression in different surrogate molecular subtypes of breast carcinoma

作　　者：曾文钦[1] 杨宇琼 卢善明 朱文标 ZENG Wenqin;YANG Yuqiong;LU Shanming;ZHU Wenbiao(Department of Anatomy;Department of Pathology,Medical College of Jiaying University;Department of Pathology,The People＇s Hospitalof Meizhou/The Meizhou Affiliated Hospital of Sun Yat-sen University,Meizhou 514031,China)

机构地区：[1]嘉应学院医学院解剖教研室,广东梅州514031 [2]嘉应学院医学院病理教研室,广东梅州514031 [3]梅州市人民医院//中山大学附属梅州医院病理科,广东梅州514031

出　　处：《分子影像学杂志》2018年第4期493-498,共6页Journal of Molecular Imaging

基　　金：广东省医学科学技术研究基金(B2017076);梅州市医药卫生科研基金(2017-B-63)

摘　　要：目的比较GATA3结合蛋白(GATA3)、特异性囊肿病液体蛋白15(GCDFP15)和乳腺珠蛋白(MGB)在原发和配对淋巴结转移性乳腺癌替代分子分型的敏感性,探讨GATA3在病理诊断的应用价值。方法选取2013年3月～2016年3月在梅州市人民医院病理科确诊的原发和配对淋巴结转移性乳腺癌患者64人,运用免疫组织化学方法和荧光原位杂交技术替代多基因分子检测,把乳腺癌分为:激素受体阳性、HER2阴性(A型);激素受体阳性、HER2阳性(B型);激素受体阴性、HER2阳性(C型);三阴(D型),每型各16例。使用组织芯片免疫组织化学方法检测GATA3、GCDFP15和MGB在原发和配对淋巴结转移性乳腺癌替代分子分型的敏感性,利用H-score评分(0～300):计算染色程度(0～3+)和染色范围(0%～100%),设定H-score评分得分界值≥50作为阳性结果评定3种抗体在替代分子分型的敏感性。结果 GATA3在A型和B型原发和配对淋巴结转移性乳腺癌的敏感性明显优于其它两种抗体,差异有统计学意义(P<0.05);而GATA3在C型和D型的敏感性与其它两种抗体相比未显其优越性,差异无统计学意义(P>0.05)。GATA3在乳腺癌替代分子分型的表达程度不同:在A型和B型显示高表达;在C型和D型显示中、低表达;而GCDFP15和MGB在替代分子分型中表达程度无差异。GATA3在原发和配对淋巴结转移性乳腺癌表达显示很好的一致性,Kappa值为0.826>0.75,而GCDFP15的Kappa值为0.492<0.75,MGB的Kappa值为0.593<0.75,显示一般的一致性。结论 GATA3在原发和配对淋巴结转移性乳腺癌表达有很好的一致性,GATA3在乳腺癌替代分子分型中敏感性有差异:GATA3在A型和B型显示高表达和高敏感,GATA3在C型显示中度表达和敏感,在三阴癌显示低表达和低敏感性。应重新评估GATA3在激素受体阴性乳腺癌尤其是三阴癌中的诊断价值。Objective To compare the sensitivity on GATA3 and GCDFP15 and MGB in different surrogate molecular subtypesof paired primary and lymph node metastatic breast carcinomas,and to explore the value of the GATA3 in pathologicaldiagnosis. Methods Between March 2013 and March 2016, we retrieved 64 cases of paired primary and lymph node metastaticbreast carcinomas from the pathology archive at the Meizhou People＇s Hospital. According to emerging St Gallen2015Consensus, the four molecular subtypes was divided into A, B, C, D, each types （n=16）. Tissue microarrays were created, thesensitivity of monoclonal antibodies to GATA3, GCDFP15 and MGB in different surrogate molecular subtypes of breastcarcinoma by using immunohistochemical staining. Staining intensity （0-3＋） and extent （0% to 100%） were scored with an H-score calculated （range, 0 to 300）. Sensitivities by the H-score cutoffs ≥50 for a positive result in different surrogate molecularsubtypes of paired primary and lymph node metastatic breast carcinomas among GATA3, GCDFP15 and MGB. Results GATA3 was significantly more sensitive than GCDFP15 and MGB in breast cancer of A and B type, （P〈0.05） rather than C, andD subtype （P〉0.05）. GATA3 staining had significant differences among different subtypes. GATA3 shows diffuse strongstaining in A and B subtypes. GATA3 shows patch low, moderate staining in C and D subtypes. GCDFP15 and MGB staininghad no significant differences among different subtypes. Significantly good coincidence was observed between primary andmetastatic breast carcinomas. GATA3 expression [kappa value=0.826〉0.75] as compared with the coincidence of GCDFP15[kappa value=0.492〈0.75] and MGB [kappa value=0.593〈0.75] （P〈0.05）. Conclusion The matched primary and metastatic tumorexpression of GATA3 is good coincidence. GATA3 expression was not the same sensitive as different surrogate molecularsubtype of breast cancer. GATA3 expression was superior to GCDFP and MGB in A and B subtypes. GATA3 expression wasslight

关 键 词：GATA3结合蛋白 乳腺癌替代分子分型 免疫组织化学 特异性囊肿病液体蛋白15 乳腺珠蛋白 

分 类 号：R737.9[医药卫生—肿瘤]