本文關(guān)鍵詞： 乳腺癌 分子分型 臨床病理特征 耐藥基因　出處：《安徽醫(yī)科大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:探討乳腺癌各個分子分型的臨床病理特點,對每種分子分型中相關(guān)耐藥基因表達有無差異進行研究,分析各分子分型乳腺癌與細胞毒藥物敏感性相關(guān)關(guān)系,為臨床不同分子分型乳腺癌化療提供依據(jù)。方法:收集并分析2014年1月~2016年12月在我科手術(shù)的乳腺癌患者信息,入組156例,發(fā)病年齡24~78歲,中位年齡48歲的乳腺癌患者,根據(jù)ER(Estrogen Receptor,雌激素受體)、PR(Progesterone Receptor,孕激素受體)、Her-2(Human Epidermal Growth Factor Receptor 2,人類表皮生長因子受體2)、Ki-67的表達的情況,劃分為4個分子亞型:Luminal A型、Luminal B型、Her-2過表達型、Basal-Like型,對比分析4種分子分型患者的發(fā)病率、年齡分布特點和臨床病理特征與分子分型之間有無相關(guān)性。同時,通過現(xiàn)有病理資料,分析不同分子分型中三種耐藥基因P-gp(P-glycoprotein)、GST-π(Glutathione-S-Transferase-π)、Topo II(Topoisomerase II)的表達差異,為臨床治療方案選擇提供方向。結(jié)果:入組乳腺癌4種分子分型中,Luminal A型67例(42.9%),Lumin al B型44例(28.2%),Her-2過表達型21例(13.5%),Basal-Like型24例(15.4%);分子亞型在年齡階段分布無統(tǒng)計學(xué)差異(P0.05);腫瘤T分期分布無統(tǒng)計學(xué)差異(P0.05);淋巴結(jié)陽性情況及TNM分期有統(tǒng)計學(xué)差異(P0.05),三種耐藥基因在4種分子分型乳腺癌患者中表達具有統(tǒng)計學(xué)差異(P0.05),P-gp陽性的病例數(shù)為83例,53.2%。Luminal B型P-gp陽性達79.5%,提示更容易產(chǎn)生耐藥;Basal-Like型P-gp表達較低33.3%。GST-π表達該基因比例較低48例(30.8%),其中Basal-Like過表達型表達率最高達15例(62.5%),Luminal A表達率最低較低共12例(17.9%)。TopoⅡ表達共90例(57.7%),其中Her-2表達最高18例(85.7%),Basal-Like最低6例(29.2%)。結(jié)論:乳腺癌分子分型與臨床治療的敏感性及預(yù)后有相關(guān)性,能夠反映乳腺癌的生物學(xué)特點,對于該類疾病治療方案及病患預(yù)后預(yù)測有指導(dǎo)價值。
[Abstract]:Objective: to investigate the clinicopathological characteristics of each molecular type of breast cancer, to study the differences in the expression of related drug resistance genes in each molecular classification, and to analyze the relationship between each molecular type of breast cancer and cytotoxic drug sensitivity. Methods: from January 2014 to December 2016, we collected and analyzed the information of 156 breast cancer patients who had been operated in our department from January 2014 to December 2016. The age of breast cancer was 2478 years old and the median age was 48 years old. According to the expression of ER(Estrogen receptor, estrogen receptor progesterone receptor, progesterone receptor, progesterone receptor Her-2human Epidermal Growth Factor Receptor 2 and human epidermal growth factor receptor 2ki-67, four molecular subtypes are classified as Basal-Like type. The incidence, age distribution, clinicopathological characteristics and molecular typing of the patients with four molecular types were compared and analyzed. At the same time, based on the existing pathological data, To analyze the difference of expression of three drug resistance genes (P-gpCP-glycoprotein) GST- 蟺 -Glutathione-S-Transferase- 蟺 / Topo II(Topoisomerase II in different molecular typing, and to analyze the expression of GST- 蟺 -Glutathione-S-Transferase- 蟺 in different molecular typing. Results: among the 4 molecular types of breast cancer, 67 cases of Luminal A type and 44 cases of Lumin al type B had Her-2 overexpression in 21 cases with 13.5B type Basal-Like type (24 cases), and there was no significant difference in the distribution of molecular subtypes in age stage (P 0.05). There was no statistical difference in the distribution of tumor T stage (P 0.05), the positive status of lymph nodes and TNM stage were significantly different (P 0.05). The number of patients with three drug resistance genes expressed in 4 molecular type breast cancer patients with P 0.05 P GP positive was 83 cases. 53.2.The positive rate of P-gp of Luminal B was 79.5a, which suggested that the expression of P-gp of Basal-Like type was more likely to produce a lower expression rate of 33.3.GST- 蟺 in 48 patients with lower expression of this gene. The highest expression rate of Basal-Like overexpression type was up to 62.5Luminal A in 15 cases. The lowest expression rate of PGP 鈪，

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