溴结构域蛋白4在乳腺分泌型癌的临床病理意义  

The Clinicopathological Significance of Bromodomain-Containing Protein 4 in Secretory Mammary Carcinoma

作　　者：吴伟清 连渊娥[2] 黄建平[2] 杨映红[2] WU Weiqing;LIAN Yuan’e;HUANG Jianping;YANG Yinghong(Department of Pathology,Fuqing City Hospital Affiliated to Fujian Medical University,Fuqing,Fujian 350300,China;Department of Pathology,the Union Hospital of Fujian Medical University,Fuzhou,Fujian 350001,China)

机构地区：[1]福建医科大学附属福清市医院病理科,福建福清350300 [2]福建医科大学附属协和医院病理科,福建福州350001

出　　处：《中国医药指南》2025年第11期37-40,共4页Guide of China Medicine

摘　　要：目的分析溴结构域蛋白4(BRD4)及其下游调控因子在乳腺分泌型癌与高度恶性的三阴性(ER、PR、HER2均为阴性表达)乳腺癌的表达情况,探讨具有惰性生物学行为的三阴性肿瘤有别于高度恶性的三阴性乳腺癌的分子特征。方法收集2010年1月至2019年12月福建医科大学附属协和医院8例乳腺分泌型癌和26例高度恶性的三阴性乳腺癌的临床及病理资料。采用免疫组织化学技术检测这34例乳腺癌BRD4、C-MYC、CyclinD1、Ki-67蛋白的表达情况,并分析蛋白表达水平的相关性。结果8例分泌型癌组织形态学典型,均为三阴性乳腺癌且伴有基底样免疫表型,4例伴有腋窝淋巴结转移,1例失访,7例随访43~140个月均未见复发及转移。高度恶性的三阴性乳腺癌亚群BRD4、C-MYC、Ki-67两两之间的表达存在正相关关系(P<0.05)。C-MYC与CyclinD1之间存在正相关关系(P<0.05)。分泌型癌BRD4、C-MYC、Ki-67的表达水平低于高度恶性的三阴性乳腺癌(P<0.05)。CyclinD1在分泌型癌和高度恶性的三阴性乳腺癌的表达差异无统计学意义(P>0.05)。结论BRD4可能通过调控C-MYC、Ki-67来影响高度恶性的三阴性乳腺癌亚群的发生发展。分泌型癌BRD4、C-MYC、Ki-67的表达水平低于高度恶性的三阴性乳腺癌,这为分泌型癌有别于高度恶性的三阴性乳腺癌的分子特征提供更多依据,并为临床精准治疗提供参考。Objective To investigate the expression of BRD4 and its downstream regulators in secretory carcinoma and highly malignant triple negative breast cancer,and to explore the molecular characteristics of secretory carcinoma with inert biological behavior different from highly malignant triple negative breast cancer.Methods Collect clinical and pathological data from 8 cases of secretory carcinoma of the breast and 26 cases of highly malignant triple-negative breast cancer(TNBC)at the Affiliated Union Hospital of Fujian Medical University from January 2010 to December 2019.Immunohistochemical(IHC)technique was employed to detect the expression of BRD4,C-MYC,CyclinD1,and Ki-67 proteins in these 34 breast cancer cases,followed by analysis of correlations between their expression levels.Results 8 cases of secretory carcinoma were all with basal-triple negative breast cancer immunophenotyping.Four patients were associated with axillary lymph node metastasis.One case was lost to follow-up and 7 cases were followed up for 43-140 months without recurrence or metastasis.There was a positive correlation between pairings of BRD4,C-MYC and Ki-67 in the highly malignant subgroup(P<0.05).There was a positive correlation between C-MYC and cyclinD1(P<0.05).The expression levels of BRD4,C-MYC and Ki-67 in secretory carcinoma were significantly lower than those in highly malignant triple negative breast cancer(P<0.05),but the expression of cyclinD1 was no difference(P>0.05).Conclusions BRD4 may affect the occurrence and development of basal triple negative breast cancer by regulating C-MYC and Ki-67.The expression levels of BRD4,C-MYC and Ki-67 were significantly lower in the secretory carcinomas than highly malignant triple negative breast cancer,which provided molecular evidence for the differentiation of secretory carcinoma from highly malignant triple negative breast cancer,and provide reference for precise clinical treatment.

关 键 词：乳腺癌 溴结构域蛋白4 分泌型癌 三阴性乳腺癌 

分 类 号：R737.9[医药卫生—肿瘤]