三阴型乳腺癌中Trop2、β-catenin的表达与临床病理特征、预后的关系  

Trop2 andβ-catenin expression in triple negative breast cancer and relationship with clinicopathological characteristics and prognosis

作　　者：王雅娟 王媛 任新瑜[2] WANG Yajuan;WANG Yuan;REN Xinyu(Department of Pathology,Beijing Longfu Hospital,Beijing 100010,China;Department of Pathology,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences,Beijing 100730,China)

机构地区：[1]北京市隆福医院病理科,北京100010 [2]中国医学科学院北京协和医院病理科,北京100730

出　　处：《临床与实验病理学杂志》2024年第11期1181-1187,共7页Chinese Journal of Clinical and Experimental Pathology

基　　金：精鉴病理乳腺癌研究基金(JJ1S2021-002)。

摘　　要：目的探讨Trop2、β-catenin在三阴型乳腺癌(triple negative breast cancer,TNBC)中的表达及其与临床病理特征、预后的关系。方法收集TNBC患者的临床资料,将TNBC按HER2-0、HER2-低表达(1+,2+FISH阴性)进一步分类。采用免疫组化法检测石蜡包埋组织中Trop2和β-catenin的表达,分析Trop2、β-catenin和HER2与临床病理特征、预后的关系。结果180例TNBC中,Trop2高表达率为60.6%(109/180),β-catenin异常表达率为71.7%(129/180),两者共表达率为48.9%(88/180),χ^( 2)检验显示与Trop2低表达者相比,Trop2高表达患者中β-catenin异常表达率更高(80.7%vs 57.7%,P<0.001)。Trop2高表达、β-catenin异常表达患者中AJCC分期晚(P=0.006,P=0.001)、远处转移比例更高(P=0.005,P=0.006);HER2-低表达比例更低(P=0.009,P=0.005)。Trop2高表达患者中淋巴结转移的比例更高(P=0.031);年龄<50岁患者比例更低(P=0.035)。β-catenin异常表达患者中组织学分级高(P=0.014)。患者中位随访时间为69.5个月,3.3%失访(6/180),36.1%复发(65/180),19.4%死亡(35/180)。Kaplan-Meier生存分析显示,Trop2高表达(P=0.017,P=0.001)、β-catenin异常表达(P=0.030,P=0.007)与Trop2(高)/HER2(0)/β-catenin(异常)均显著缩短患者的无瘤生存期(disease-free survival,DFS)和总生存期(overall survival,OS)(P均<0.001)。Cox回归分析显示,AJCC分期晚(HR=2.543,P<0.001)、基底样TNBC(HR=3.948,P=0.024)、Trop2(高)/HER2(0)/β-catenin(异常)患者死亡风险显著增高(HR=4.452,P<0.001);肿瘤浸润淋巴细胞(tumor infiltrating lymphocytes,TILs)≥30%的患者死亡风险显著降低(HR=0.341,P=0.044)。结论TNBC中Trop2、β-catenin与HER2表达具有相关性;Trop2(高)/HER2(0)/β-catenin(异常)可作为TNBC预后的预测指标。Purpose To investigate the expression of Trop2 andβ-catenin in triple negative breast cancer(TNBC)and to explore their relationship with clinicopathologic features and prognosis.Methods Clinicopathologic features and prognosis of TNBC patients were collected.TNBC was classified into HER2-low(1+,2+FISH negative)and 0 expression.The expression of Trop2 andβ-catenin in tumors was evaluated by immunohistochemistry in paraffin embedded tissue.The correlation between Trop2,β-catenin expression and clinicopathologic features and prognosis was analyzed.Results Among 180 cases of TNBC,there were 60.6%(109/180)high Trop2 expression and 71.7%(129/180)abnormalβ-catenin expression,and 48.9%(88/180)co-expression.Chi-square test showed compared with Trop2-low TNBC patients,Trop2-high TNBC patients had high abnormal expression rate ofβ-catenin(80.7%vs 57.7%,P<0.001).TNBC patients with Trop2-high orβ-catenin abnormal expression had higher AJCC stage(P=0.006,P=0.001),distant metastasis(P=0.005,P=0.006),and lower HER2-low(P=0.009,P=0.005).TNBC patients with Trop2-high had higher lymph node metastasis(P=0.031)and lower age<50 years(P=0.035).TNBC patients withβ-catenin abnormal expression had higher histological grade(P=0.014).The median follow-up time was 69.5 months,3.3%(6/180)were lost to follow-up,36.1%(65/180)relapsed,and 19.4%(35/180)died.Survival analysis showed that Trop2-high(P=0.017,P=0.001),β-catenin positive(P=0.030,P=0.007)and Trop2(high)/HER2(0)/β-catenin(abnormal)(P<0.001)had shorter disease-free survival(DFS)and over-all survival(OS).Cox regression analysis showed that the patients with high AJCC stage(HR=2.543,P<0.001)and basal-like TNBC(HR=3.948,P=0.024),Trop2(high)/HER2(0)/β-catenin(abnormal)(HR=4.452,P<0.001)had a higher mortality risk,but TILs≥30%(HR=0.341,P=0.044)had a lower mortality risk.Conclusion The expression of Trop2,β-catenin and HER2 were correlated in TNBC.Trop2(high)/HER2(0)/β-catenin(abnormal),can predict prognosis.

关 键 词：乳腺肿瘤 三阴型乳腺癌 Trop2 Β-CATENIN HER2 预后 

分 类 号：R737.9[医药卫生—肿瘤]