發(fā)布時間：2018-07-29 20:37

【摘要】：目的:探討浸潤性乳腺癌患者原發(fā)灶中骨形成蛋白(bone morphogenetic protein-2,BMP-2)及雄激素受體(androgen receptor,AR)的表達(dá)情況,并探討其與臨床病理特征的關(guān)系。方法:收集新疆醫(yī)科大學(xué)附屬腫瘤醫(yī)院2009年1月至2014年12月經(jīng)手術(shù)切除并經(jīng)病理診斷的浸潤性乳腺癌123例,采用免疫組織化學(xué)方法檢測AR,BMP-2在浸潤性乳腺癌患者原發(fā)灶中的表達(dá)情況,并分析其與臨床病理特征的相關(guān)性。結(jié)果:本研究所選123例浸潤性乳腺癌病例中,BMP-2陽性共計114例(92.7%),AR陽性共計98例(79.7%);在腫瘤大小分組中,腫瘤5cm病例中AR陽性率100%,2-5cm病例中AR陽性率90.7%,"f2cm病例中AR陽性率71.6%,三組表達(dá)有統(tǒng)計學(xué)差異(=35.168,P0.01);在不同組織學(xué)分級分組中,Ⅰ級AR陽性率80%,Ⅱ級AR陽性率88.9%,Ⅲ級AR陽性率59.5%,三組表達(dá)差異有統(tǒng)計學(xué)意義(=14.494,P=0.025);Ⅰ級BMP-2陽性率80%,Ⅱ級BMP-2陽性率97.5%,Ⅲ級BMP-2陽性率83.3%,表達(dá)差異有統(tǒng)計學(xué)意義(=13.853,P=0.031);ER陽性組AR陽性率87.4%,ER陰性的AR陽性率53.6%,兩組表達(dá)差異有統(tǒng)計學(xué)意義(=16.868,P=0.001);PR陽性組AR表達(dá)率87.5%,PR陰性組AR表達(dá)率60%,兩組表達(dá)差異有統(tǒng)計學(xué)意義(=12.822,P=0.005);AR陽性組BMP-2陽性率95.9%,AR陰性組BMP-2陽性率80%,兩組表達(dá)差異有統(tǒng)計學(xué)意義(=8.909,P=0.031);在分子分型中的陽性率分別為,Luminal A型(80.0%)、Luminal B型(87.4%)、Her-2過表達(dá)型(52.6%)、Basal-like型(0),差異有統(tǒng)計學(xué)意義(=23.456,P=0.005)。本研究中發(fā)生骨轉(zhuǎn)移病例85例,未發(fā)生骨轉(zhuǎn)移病例38例,有腋窩淋巴結(jié)轉(zhuǎn)移組AR陽性率88.4%,無腋窩淋巴結(jié)轉(zhuǎn)移組68.5%,兩組之間AR表達(dá)差異有統(tǒng)計學(xué)意義(=8.615,P=0.035);有神經(jīng)脈管侵犯組的AR陽性表達(dá)率為96.3%,無神經(jīng)脈管侵犯組陽性表達(dá)率75.0%,兩組之間AR表達(dá)差異有統(tǒng)計學(xué)意義(=34.143,P0.01);而在年齡,臨床分期,骨轉(zhuǎn)移、Her-2陽性、陰性組,Ki-67陽性、陰性組中的AR表達(dá)差異無統(tǒng)計學(xué)意義(P0.05);在年齡、臨床分期、腫瘤大小、神經(jīng)脈管侵犯、淋巴結(jié)轉(zhuǎn)移、骨轉(zhuǎn)移及ER,PR,Her-2,Ki-67等分組中BMP-2表達(dá)差異無統(tǒng)計學(xué)意義(P0.05)。結(jié)論:在組織學(xué)分級中,Ⅱ級BMP-2陽性率、AR陽性率高于Ⅰ級、三級;在腫瘤大小分組中,AR陽性率隨著腫瘤直徑的增大而增高。在分子分型中,AR陽性率由高到低分別為Luminal B型、Luminal A型、Her-2過表達(dá)型、Basal-like型,BMP-2表達(dá)率由高到低分別為Basal-like型、Luminal B、Luminal A型、Her-2過表達(dá)型。在淋巴結(jié)轉(zhuǎn)移組中,AR陽性率在有腋窩淋巴結(jié)轉(zhuǎn)移組高于無腋窩淋巴結(jié)轉(zhuǎn)移組;在神經(jīng)脈管侵犯組中,AR陽性表達(dá)率在有神經(jīng)脈管侵犯組高于無神經(jīng)脈管侵犯組。AR陽性組BMP-2陽性率高于AR陰性組BMP-2陽性率,而且AR高表達(dá)的組織中BMP-2也呈高表達(dá),AR低表達(dá)的組織中BMP-2也呈低表達(dá)。AR與ER、PR在乳腺癌組織中的表達(dá)具有一定的相關(guān)性,并在乳腺癌的浸潤及轉(zhuǎn)移過程中發(fā)揮重要作用;BMP-2無法獨(dú)立為浸潤性乳腺癌患者骨轉(zhuǎn)移提供風(fēng)險預(yù)警。
[Abstract]:Objective: to investigate the expression of bone morphogenetic protein (bone morphogenetic protein-2BMP-2 (BMP-2) and androgen receptor AR (androgen receptor AR) in primary lesions of invasive breast cancer and their relationship with clinicopathological features. Methods: 123 cases of invasive breast cancer diagnosed by pathology from January 2009 to December 2014 in Cancer Hospital affiliated to Xinjiang Medical University were collected. Immunohistochemical method was used to detect the expression of ARN BMP-2 in primary lesions of invasive breast cancer and its correlation with clinicopathological features was analyzed. Results: in 123 cases of invasive breast cancer, 114 cases (92.7%) were positive for BMP-2 and 98 cases (79.7%) were positive for AR. The positive rate of AR in tumor 5cm cases was 90.7 in 2 ~ 5cm cases, "the positive rate of AR in f2cm cases was 71.6, there was statistical difference among the three groups (P 0.01), and in different histological grading groups, there was a significant difference in AR positive rate among the three groups (P < 0.05). The positive rate of AR was 80 in grade 鈪，

本文編號：2153944