三阴性乳腺癌组织中p53表达对患者预后的影响  

Effect of p53 Expression on Prognosis in Triple Negative Breast Cancer

作　　者：杨喜佳 刘琪 YANG Xi-jia;LIU Qi(Department of General Surgery,Xi'an High-Tech Hospital,Xi'an 710061)

机构地区：[1]西安高新医院普外科,陕西西安710061 [2]杨凌示范区医院肝胆普外科,陕西杨凌712100

出　　处：《医学临床研究》2021年第9期1324-1327,共4页Journal of Clinical Research

基　　金：西安市卫生健康委员会科研项目(编号:2020yb61)。

摘　　要：【目的】探讨p53在三阴性乳腺癌中的表达情况及其与预后的关系。【方法】选取本院收治的可手术三阴性乳腺癌患者79例,取术中新鲜癌组织及癌旁组织,采用免疫组化法检测p53表达情况。对患者进行随访,观察患者复发转移情况及总生存期(OS),并分析复发转移、OS与p53表达的关系。【结果】三阴性乳腺癌中p53的表达率高达40.51%(32/79),高于癌旁组织飽11.39%(9/79),且差异有显著性(P<0.05)。p53高表达组淋巴结分期(N)N_(3)期比例及组织学Ⅲ级比例高于p53低表达组(均P<0.05)。随访时间36-60(49.6±4.9)个月,共70例患者得到随访,9例失访。共17例患者复发,高表达组复发率显著高于低表达组,且差异有显著性(P<0.05)。共11例患者转移.高表达组转移率显著高于p53低表达组,且差异有显著性(P<0.05)。随访期内有17例(24.28%)死亡。Kaplan-Meier法并Log-rank检验结果显示,p53高表达的三阴性乳腺癌患者OS较p53低表达的三阴性乳腺癌患者缩短(P<0.05)。多因素COX结果显示,肿瘤大小、淋巴结分期、p53表达、组织学分级是影响三阴性乳腺癌患者死亡的独立预后因素(P<0.05)。【结论】三阴性乳腺癌中p53表达上调,且高p53的患者预后不良,复发转移及死亡风险增加。【Objective】To explore the expression of p53 in triple-negative breast cancer and its relationship with prognosis.【Methods】A total of 79 patients with operable triple-negative breast cancer treated in our hospital were selected.Fresh cancer tissues and adjacent tissues were collected during operation,and p53 expression was detected by immunohistochemistry.The patients were followed up to observe the recurrence,metastasis and overall survival(OS).The relationship of p53 expression with recurrence,metastasis and OS was analyzed.【Results】The positive expression rate of p53(40.51%)in triple-negative breast cancer was higher than that in adjacent tissues(11.39%),and the difference was statistically significant(P<0.05).The proportion of N3 and gradeⅢin p53 high expression group was higher than that in p53 low expression group(both P<0.05).The follow-up time was 36-60(49.6±4.9)months.A total of 70 patients were followed up and 9 were lost to follow-up.A total of 17 patients relapsed.Of which,the recurrence rate in the p53 high expression group was significantly higher than that in the p53 low expression group,and the difference was statistically significant(P<0.05).A total of 11 patients had metastasis.The metastasis rate in the p53 high expression group(32.14%)was significantly higher than that in the p53 low expression group,and the difference was statistically significant(P<0.05).During the follow-up period,17 patients died.Kaplan-M&er method and Log-rank test results showed that patients with triple-negative breast cancer plus high expression of p53 had shorter OS than those patients with triplenegative breast cancer plus low expression of p53(P<0.05).Multivariate COX results showed that tumor size(T),lymph node stage(N),p53 expression,and histological grade were independent prognostic factors affecting the death of triple-negative breast cancer patients(P<0.05).【Conclusion】The p53 expression is up-regulated in triple negative breast cancer,and patients with high p53 expression have a poor prognosi

关 键 词：乳腺肿瘤/病理学 受体 erbB—2 雌激素类 孕酮 肿瘤抑制蛋白质P53 预后 

分 类 号：R737.9[医药卫生—肿瘤]