乳腺癌中Ki-67、EGFR及E-cad表达及其对预后的影响研究  

Expressions of Ki-67,EGFR,and E-cad in breast cancer and their effects on prognosis

作　　者：程辰[1] 李雪平 徐艺 赵红艳[1] 赵海涛[4] Cheng Chen;Li Xueping;Xu Yi;Zhao Hongyan;Zhao Haitao(Department of Ultrasound,Lianyungang Hospital of Traditional Chinese Medicine,Lianyungang 222004,China;Department of Ultrasound,Lianyungang First People's Hospital,Lianyungang 222000,China;Department of Pharmacy,Lianyungang First People's Hospital,Lianyungang 222000,China;Department of General Surgery,Lianyungang Hospital of Traditional Chinese Medicine,Lianyungang 222004,China)

机构地区：[1]连云港市中医院超声科,连云港222004 [2]连云港市第一人民医院超声科,连云港222000 [3]连云港市第一人民医院药学部,连云港222000 [4]连云港市中医院普外科,连云港222004

出　　处：《国际医药卫生导报》2022年第11期1486-1491,共6页International Medicine and Health Guidance News

基　　金：连云港重点研发计划(社会发展)项目(SF2112);连云港市中医院"赵化南"青年科技基金项目(Lzyq2106)。

摘　　要：目的探讨乳腺癌中细胞增殖相关抗原(Ki-67)、表皮生长因子受体(EGFR)和上皮钙黏附蛋白(E-cad)表达及其对预后的影响。方法回顾性研究2015年5月至2021年12月连云港市第一人民医院及连云港市中医院经手术切除的乳腺癌标本167例,随访并整理患者病例资料,运用SPSS 24.0软件进行统计学分析,计数资料的组间比较采用卡方检验,采用Spearman分析评价生物学预后因子与临床病理特征、预后评价体系Neo-bioscore相关性的研究;总生存期、生存分析观察采用Kaplan-Meier法进行单因素分析并绘制生存曲线;采用Cox回归模型开展多因素分析,进一步排除混杂因素所产生的影响。结果乳腺癌标本167例,其患者平均年龄为46.4岁。(1)乳腺癌患者的病理分子分型与Ki-67、EGFR表达差异均有统计学意义(χ^(2)=30.463、P<0.001,χ^(2)=25.652、P<0.001);Ki-67与EGFR,EGFR与E-cad之间的表达水平,差异均有统计学意义(χ^(2)=7.167、P=0.007,χ^(2)=18.576、P<0.001)。(2)EGFR与Ki-67的表达水平有紧密的正相关性(r=0.207,P=0.007),与E-cad的表达水平有显著的负相关性(r=-0.325,P<0.001);乳腺癌Neo-bioscore评分体系分值高低与Ki-67、EGFR的表达水平均呈正相关性(r=0.324、P<0.001,r=0.176、P=0.023),与E-cad的表达水平呈负相关性(r=-0.162,P=0.037)。(3)通过Kaplan-Meier单因素及COX模型多因素生存分析显示:乳腺癌患者的Ki-67表达水平和Neo-bioscore评分是影响乳腺癌预后的因素(χ^(2)=3.950、P=0.047,χ^(2)=13.372,P=0.004),且为影响乳腺癌患者生存的独立危险因素。结论Ki-67、EGFR及E-cad表达对增殖活性分子表达等产生了辅助判断作用,使得个性化、靶向治疗成为可能,与乳腺癌患者的预后有直接或间接相关性,动态监测肿瘤靶向治疗效果,从而更好地为临床服务。Objective To investigate the expressions of Ki-67,EGFR,and E-cad in breast cancer and their effects on prognosis.Methods One hundred and sixty-seven breast cancer specimens from Lianyungang First People's Hospital and Lianyungang Hospital of Traditional Chinese Medicine between May 2015 and December 2021 were retrospectively studied.The patients were followed up,and their data were sorted out.The SPSS 24.0 software was used for statistical analysis.The chi-square test was used to compare the enumeration data between the groups.Spearman analysis was used to evaluate the correlation of biological prognostic factors with clinicopathological characteristics and the Neo-bioscore prognostic evaluation system.The overall survival and survival analysis were observed by the Kaplan-Meier method.Single factor analysis was performed,and the survival curves were drawn.Cox regression model was used to carry out multivariate analysis to further exclude the influence of confounding factors.Results The patients was averagely 46.4 years old.The pathological molecular typing of breast cancer was significantly different from the expressions of Ki-67 and EGFR(χ^(2)=30.463,P<0.001;χ^(2)=25.652,P<0.001);there were statistical differences between the expressions of Ki-67 and EGFR and between the expressions of EGFR and E-cad(χ^(2)=7.167,P=0.007;χ^(2)=18.576,P<0.001).There was a close positive correlation between the expression levels of EGFR and Ki-67(r=0.207,P=0.007),and a negative correlation between the expression levels of EGFR and E-cad(r=-0.325,P<0.001);the Neo-bioscore score of breast cancer was positively correlated with the expression levels of Ki-67 and EGFR(r=0.324,P<0.001;r=0.176,P=0.023),and negatively with the expression level of E-cad(r=-0.162,P=0.037).The Kaplan-Meier univariate and COX model multivariate survival analysis showed that the Ki-67 expression level and Neo-bioscore score of breast cancer were the prognostic factors of breast cancer(χ^(2)=3.950,P=0.047;χ^(2)=13.372,P=0.004),and were the independent risk

关 键 词：乳腺癌 KI-67 EGFR E-CAD 生存分析 

分 类 号：R737.9[医药卫生—肿瘤]