發(fā)布時間：2018-05-14 03:37

  本文選題：乳腺浸潤性導(dǎo)管癌 + 導(dǎo)管原位癌��； 參考：《西南醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的:探討乳腺組織中B細胞淋巴瘤因子9(B-cell lymphoma 9,BCL9)和β-鏈蛋白(β-catenin)的表達及其與乳腺癌臨床病理特征的關(guān)系。方法:共收集乳腺癌術(shù)后標本228例,其中浸潤性導(dǎo)管癌(invasive ductal carcinoma,IDC)120例,導(dǎo)管原位癌伴微浸潤(ductal carcinoma in situ with microinvasion,DCIS-MI)38例,導(dǎo)管原位癌(ductal carcinoma in situ,DCIS)50例,乳腺癌旁正常組織20例。采用免疫組織化學(xué)Envision染色法檢測BCL9及β-catenin蛋白在上述組織中的表達情況,分析其在不同組織中的表達差異、在IDC中與臨床病理特征的關(guān)系及二者的相關(guān)性。應(yīng)用SPSS17.0軟件分析系統(tǒng)進行統(tǒng)計學(xué)處理,計數(shù)資料采用卡方檢驗,Fisher確切概率法對數(shù)據(jù)進行兩兩比較,相關(guān)性分析采用Spearman相關(guān)檢驗。結(jié)果以P0.05為差異有統(tǒng)計學(xué)意義。結(jié)果:1.BCL9在乳腺正常組織、DCIS、DCIS-MI、IDC中的表達陽性率分別為0、32%、44.7%、53.3%,四組間差異有統(tǒng)計學(xué)意義(P0.05)。BCL9在DCIS、DCIS-MI、IDC組表達均高于乳腺正常組織組(P0.05);IDC組表達高于DCIS組,差異有統(tǒng)計學(xué)意義(P0.05),DCIS-MI組表達與DCIS組、IDC組無差異(P0.05)。2.β-catenin蛋白在乳腺正常組織、DCIS、DCIS-MI、IDC中的異常表達率分別為20%、56%、60.5%、71.7%,四組間差異有統(tǒng)計學(xué)意義(P0.05)。其中β-catenin異常表達率在DCIS、DCIS-MI、IDC組中高于正常組織組,差異均具有統(tǒng)計學(xué)意義(P0.05);IDC組異常表達率高于DCIS組(P0.05),然而DCIS-MI組與IDC組、DCIS組之間無差異(P0.05)。3.BCL9表達與腫瘤大小、ER、PR、HER-2表達、Ki-67及分子分型相關(guān)(P0.05),與患者年齡、WHO分級、脈管瘤栓、淋巴結(jié)轉(zhuǎn)移、遠處轉(zhuǎn)移及腫瘤p TNM分期無關(guān)(P0.05)。4.β-catenin表達與脈管瘤栓、ER、HER-2表達、分子分型相關(guān)(P0.05),與患者年齡、腫瘤大小、淋巴結(jié)轉(zhuǎn)移、遠處轉(zhuǎn)移、WHO分級、腫瘤p TNM分期及PR、Ki-67無關(guān)(P0.05)。5.經(jīng)Spearman相關(guān)檢驗分析得出在乳腺癌中BCL9陽性表達和β-catenin蛋白異常表達呈正相關(guān)關(guān)系(r=0.612,P=0.000)。結(jié)論:1.在乳腺正常組織、DCIS、DCIS-MI、IDC中BCL9表達逐漸增加,提示BCL9可能與乳腺腫瘤發(fā)生及腫瘤進展相關(guān);IDC組表達高于DCIS組,提示BCL9可能與導(dǎo)管原位癌發(fā)生浸潤相關(guān)。2.β-catenin在乳腺正常組織、DCIS、DCIS-MI、IDC四組異常表達率呈遞增趨勢,β-catenin的異常表達可能與乳腺癌的發(fā)生及腫瘤進展相關(guān);IDC組β-catenin異常表達率高于DCIS組,提示β-catenin的異常表達可能與導(dǎo)管原位癌發(fā)生浸潤相關(guān)。3.在IDC中腫瘤T分期越晚、ER(-)、PR(-)、HER-2陽性表達、Ki-67高表達患者BCL9陽性率越高;分子分型為Basal-like型、HER-2過表達型、Luminal B型的乳腺癌患者BCL9陽性率高于Luminal A型。4.在IDC中腫瘤伴脈管瘤栓、ER陰性、HER-2陽性者β-catenin異常表達率更高,分子分型為Basal-like型、HER-2過表達型、Luminal B型β-catenin異常表達率高于Luminal A型。5.在乳腺癌中,BCL9陽性表達和β-catenin異常表達呈正相關(guān)。
[Abstract]:Objective: to investigate the expression of B cell lymphoma factor 9(B-cell lymphoma 9 (BCL9) and 尾-chain protein (尾-catenin) and its relationship with clinicopathological features of breast cancer. Methods: a total of 228 cases of breast cancer were collected, including 120 cases of invasive ductal carcinoma, 38 cases of ductal carcinoma in situ with microinvasion-DCIS-MIM, 50 cases of ductal carcinoma in situ, and 20 cases of normal tissue adjacent to breast cancer. Immunohistochemical Envision staining was used to detect the expression of BCL9 and 尾 -catenin in these tissues. The differences of expression in different tissues, the relationship between the expression of BCL9 and 尾 -catenin in IDC and their correlation with clinicopathological features were analyzed. The SPSS17.0 software analysis system is used to deal with statistics, the counting data is compared by chi-square test and Fisher exact probability method, and the correlation analysis adopts Spearman correlation test. Results there was a significant difference between the two groups. Results 1. The positive rate of BCL9 expression in DCIS-MI-IDC in normal breast tissue was 0.32, 44.7 and 53.3, respectively. The expression of BCL9 in DCIS-MIIS-IDC group was significantly higher than that in normal breast tissue group (P0.05IDC), and the expression of BCL9 in DCIS-MI-IDC group was higher than that in normal breast tissue group (P0.05IDC group), and the positive rate of BCL9 expression in DCIS-MI-IDC group was higher than that in normal breast tissue group (P0.05IDC group). There was no significant difference in the expression of 尾 -catenin in DCIS-MI group and DCIS group. The abnormal expression rate of 尾 -catenin protein in DCIS-MI-IDC in normal breast tissue was 20 ~ 5656-MI-IDC, respectively. The difference between the four groups was significant (P 0.05). The abnormal expression rate of 尾 -catenin in DCIS-MI-IDC group was higher than that in normal tissue group. The difference was statistically significant (P 0.05). The abnormal expression rate in IDC group was higher than that in DCIS group. However, there was no difference between DCIS-MI group and IDC group. 3. The expression of BCL9 was correlated with the expression of Ki-67 and molecular type of P0.05, tumor thrombus and lymph node metastasis. The expression of 尾 -catenin was not correlated with the expression of ERHER-2 in vascular tumor thrombus, but not with age, tumor size, lymph node metastasis, distant metastasis grade, tumor p TNM stage and Ki-67 p0.05.5.The expression of 尾 -catenin was not correlated with tumor age, tumor size, lymph node metastasis, distant metastasis and p0.05n.4. 尾 -catenin expression was not associated with the expression of ERHER-2, and the expression of 尾 -catenin was not correlated with age, tumor size, lymph node metastasis. The positive expression of BCL9 and the abnormal expression of 尾 -catenin protein were positively correlated with the expression of 尾 -catenin protein in breast cancer by Spearman correlation test. Conclusion 1. The expression of BCL9 in DCIS-MI-IDC was gradually increased in normal breast tissue, suggesting that the expression of BCL9 in IDC group may be higher than that in DCIS group, which may be related to the occurrence and progression of breast tumor. These results suggest that the abnormal expression rate of 尾 -catenin may be increased in DCIS-MI-IDC group. The abnormal expression of 尾 -catenin may be associated with the occurrence and progression of breast cancer. The abnormal expression rate of 尾 -catenin in IDC group is higher than that in DCIS group. These results suggest that the abnormal expression of 尾-catenin may be related to the invasion of ductal carcinoma in situ. The higher the expression of Ki-67, the higher the positive rate of BCL9 in patients with higher expression of HER-2 in IDC, and the higher the positive rate of BCL9 in breast cancer with Basal-like and HER-2 overexpression type B is higher than that in type Luminal A. The abnormal expression rate of 尾 -catenin was higher in patients with ER negative or HER-2 positive in IDC, and the abnormal expression rate of 尾 -catenin in Basal-like type HER-2 overexpression type was higher than that in Luminal A type. 5. Positive expression of BCL9 and abnormal expression of 尾-catenin were positively correlated in breast cancer.
【學(xué)位授予單位】：西南醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R737.9

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本文編號：1886193