21基因检测对ER阳性、淋巴结阴性乳腺癌患者术后复发转移的指导价值  

Guiding value of 21-gene recurrence score assay in postoperative recurrence and metastasis of ER positive and lymph node-negative breast cancer patients

作　　者：顾玉琴 华燕艳[2] GU Yu-qin;HUA Yan-yan(Department of Oncology,Yangzhou Friendship Hospital,Yangzhou Jiangsu 225009,China;Department of Oncology,Affiliated Hospital of Jiangnan University,Wuxi Jiangsu 214062,China)

机构地区：[1]扬州友好医院肿瘤科,江苏扬州225009 [2]江南大学附属医院肿瘤科,江苏无锡214062

出　　处：《局解手术学杂志》2019年第11期906-909,共4页Journal of Regional Anatomy and Operative Surgery

摘　　要：目的探讨21基因检测在ER阳性、淋巴结阴性乳腺癌患者术后复发转移中的指导价值。方法选取2014年2月至2018年2月扬州友好医院及江南大学附属医院的ER阳性、淋巴结阴性乳腺癌患者172例,根据患者术后是否发生复发转移分为复发转移组(n=43)和未复发转移组(n=129)。所有患者均行手术治疗,根据AJCC第7版标准诊断患者的组织学分级,免疫组化法检测患者的癌转移抑制基因(PR)、细胞增殖核抗原Ki67(Ki67)、P53基因(P53)、基底细胞角蛋白CK5/6(CK5/6)、拓扑异构酶Ⅱα(TOPⅡα)以及表皮生长因子受体(EGFR)等指标。采用实时荧光聚合酶链反应(PCR)检测21基因(包括16个乳腺癌相关基因及5个参考基因)表达,计算21基因复发风险评分;对于复发转移患者查阅病历资料,记录并统计患者年龄、肿瘤直径、组织分型、Ki67、P53、TOPIIα、EGFR及CK5/6表达水平,分析不同病理组织下21基因复发风险评分,并进行单因素及多因素Logistic回归分析。结果所有ER阳性、淋巴结阴性乳腺癌患者均经病理结果最终确诊,确诊率为100.0%,病理结果中43例发生复发转移。2组患者均顺利完成21基因检测,复发转移组21基因检测评分为(37.93±6.83)分,高于未复发转移组(21.48±3.25)分,差异有统计学意义(t=12.193,P<0.05);单因素及多因素结果表明,乳腺癌不同病理组织下21基因检测评分与年龄、病理类型、组织分级、P53、TOPIIα、EGFR、CK5/6、手术方式差异无统计学意义(P>0.05);乳腺癌不同病理组织下21基因检测评分与肿瘤直径、Ki67、PR具有统计学意义(P<0.05)。结论将21基因检测用于ER阳性、淋巴结阴性乳腺癌患者术后复发转移中效果理想,有助于评估患者预后,为临床诊疗提供依据和参考。Objective To investigate the guiding value of 21-gene recurrence score assay in the recurrence and metastasis of patients with ER-positive and lymph node-negative breast cancer.Methods From February 2014 to February 2018,172 patients with ER-positive and lymph node-negative breast cancer were enrolled.According to whether the patient had recurrence or metastasis,the patients were divided into recurrence and metastasis group(n=43)and non-recurrence and metastasis group(n=129).All patients underwent surgery.The histological grades of the patients were classified according to the 7th edition AJCC staging system.The cancer metastasis suppressor gene(PR),cell proliferating nuclear antigen Ki67(Ki67),P53 gene(P53),basal cytokeratin CK5/6(CK5/6),topoisomerase Ⅱα(TOPⅡα)and epidermal growth factor receptor(EGFR)were detected by immunohistochemistry.Real-time fluorescent polymerase chain reaction(PCR)was used to detect the expression of 21 genes(including 16 breast cancer related genes and 5 reference genes),and the 21 gene recurrence score was calculated.For patients with recurrence and metastasis,clinical data were obtained to record the age,tumor diameter,tissue typing,Ki67,P53,TOPⅡα,EGFR and CK5/6 expression levels.Risk scores of 21 gene recurrence in different pathological tissues were analyzed,and single factor and multivariate logistic regression analysis were performed.Results All patients with ER-positive and lymph node-negative breast cancer were diagnosed by pathological diagnosis.The diagnosis rate was 100.0%.Among the pathological results,43 cases had recurrence and metastasis.The 21-gene recurrence score assay were successfully performed in both groups.The score of 21 genes in the recurrence and metastasis group was(37.93±6.83),which was higher than that in the non-recurrence and metastasis group(21.48±3.25)(t=12.193,P<0.05).Single factor and multi-factor results showed that there was no significant difference in 21-gene recurrence score and age,pathological type,tissue grade,P53,TOPⅡα,EGFR,CK5/

关 键 词：乳腺癌 21基因 ER阳性、淋巴结阴性 复发 转移 

分 类 号：R655.8[医药卫生—外科学]