拓扑异构酶Ⅱα蛋白在青年女性乳腺癌中的表达及其预后的关系  

Expression of TopoisomeraseⅡαprotein in young breast cancer patients and its relationship with prognosis

作　　者：林凤村 李艺江 林延宗 黄建丽 LIN Fengcun;LI Yijiang;LIN Yanzong;HUANG Jianli(Department of Radiation Oncology,Zhangzhou Hospital Affiliated to Fujian Medical University,Zhangzhou,Fujian 363000,China;Department of general surgery section,The First Affiliated Hospital of Xiamen University,Xiamen,Fujian 361000,China)

机构地区：[1]福建医科大学附属漳州市医院肿瘤放疗科,福建漳州363000 [2]厦门大学附属第一医院普通外科,福建厦门361000

出　　处：《现代医药卫生》2022年第24期4141-4147,共7页Journal of Modern Medicine & Health

基　　金：福建省自然科学基金资助项目(2020J05299)。

摘　　要：目的探讨拓扑异构酶Ⅱα(TopoⅡα)蛋白在青年女性(年龄<35岁)乳腺癌患者中的表达及其预后价值。方法回顾性分析2004年8月至2009年1月在福建医科大学附属漳州市医院经手术且病理确诊的131例乳腺癌患者,最终纳入50例患者并对其癌组织进行TopoⅡα蛋白表达的免疫组织化学检测。Kaplan-Meier法计算生存曲线,χ^(2)检验分析TopoⅡα蛋白表达与临床病理特征的关系,Cox法多因素分析TopoⅡα蛋白表达与患者预后的关系。结果本研究中TopoⅡα蛋白阳性表达率为84%(42/50),其表达情况仅与Ki67呈正相关(r=0.533,P=0.002),与肿瘤大小、淋巴结转移情况、TNM分期、分子分型、ER、PR、激素受体、HER-2无关,差异无统计学意义(P>0.05)。TopoⅡα蛋白阳性者预后较阴性者好,10年无病生存期(DFS)分别为64.3%和12.5%,差异有统计学意义(χ^(2)=9.105,P=0.003)。多因素分析显示,TopoⅡα蛋白阴性、激素受体阴性、TNM分期较晚(Ⅲ期)是青年乳腺癌患者DFS的独立预后危险因素(P=0.005,P=0.002,P=0.012);淋巴结转移、激素受体阴性、TNM分期较晚(Ⅲ期)是总生存期(OS)的独立预后危险因素(P=0.033,P=0.001,P=0.005)。结论TopoⅡα蛋白在青年女性乳腺癌组织中趋于高表达,与肿瘤增殖迅速相关,其高表达患者的DFS较长。Objective To assessed the long-term prognostic and predictive value of TopoisomeraseⅡα(TopoⅡα)expression in young patients(<35 years)with breast cancer.Methods We retrospectively analyzed 131 patients who were surgically resected and pathologically diagnosed with breast cancer in Zhangzhou Hospital Affiliated to Fujian Medical University,from August 2004 to January 2009.Fifty patients were finally enrolled for TopoⅡαexpression detection by immunohistochemistry technology.Survival rates were estimated by Kaplan-Meier method.The association of TopoⅡαexpression and clinicopathological features were studied by Chi-square test.The Cox regression model was employed for multivariate analysis.Results There were 42 of 50 patients(84%)with TopoⅡαpositive in the study.The expression of TopoⅡαwas positively correlated to Ki67(r=0.533,P=0.002)as displayed by Spearman′s correlation test.No correlation between TopoⅡαprotein expression with tumor size,lymphatic metastasis,TMN stage,molecular typing,estrogen receptor(ER),progesterone receptor(PR)and human epidermal growth factor receptor-2(HER-2)were observed(P>0.05).The 10-year DFS in TopoⅡαpositive vs.negative group were 64.3%vs.12.5%,with statistically significant difference(χ^(2)=9.105;P=0.003).In the multivariate analyses,TopoⅡαexpression,Hormone Receptor and TNM staging were independent prognostic factors for DFS in young patients with breast cancer(P=0.005,P=0.002,P=0.012,respectively).Lymphatic metastasis,Hormone Receptor and TNM staging were independent predictors for OS in multivariate analyses(P=0.033,P=0.001,P=0.005).Conclusion TopoⅡαprotein tends to be highly expressed in young patients with breast cancer,and is associated with rapid tumor proliferation.Patients with high expression of TopoⅡαprotein have a longer DFS.

关 键 词：DNA拓扑异构酶 Ⅱ型 乳腺肿瘤 预后 

分 类 号：R737.9[医药卫生—肿瘤]