【摘要】：目的:檢測三陰性乳腺癌(triple negative breast cancer,TNBC)、非三陰性乳腺癌(non-triple negative breast cancer,NTNBC)組織中的p53、Ki-67、及E-cadherin蛋白表達,探討三個指標與TNBC臨床病理特征的關(guān)系,以及三種蛋白表達的相關(guān)性。并結(jié)合臨床隨訪資料,分析上述三種蛋白的表達與TNBC患者預(yù)后的關(guān)系。方法:采用免疫組織化學染色二步法分別檢測52例TNBC、52例NTNBC中p53、Ki-67、及E-cadherin蛋白表達,分析其與TNBC患者預(yù)后的關(guān)系。結(jié)果:1.TNBC、NTNBC中p53陽性表達率分別為67.3%、44.2%,TNBC組織中p53陽性表達率高于NTNBC(χ2=5.613,P=0.018);在TNBC組織中,p53陽性表達與組織學分級、腫瘤大小、TNM分期有關(guān)(均P0.05),但與患者淋巴結(jié)轉(zhuǎn)移、年齡、絕經(jīng)狀態(tài)無關(guān)(均P0.05);生存曲線顯示TNBC組織中p53陰性表達患者總體生存率顯著高于陽性者(P0.05)。2.TNBC、NTNBC中Ki-67陽性表達率分別為80.8%、61.5%,TNBC組織中Ki-67陽性表達率高于NTNBC(χ2=4.685,P=0.030);在TNBC組織中,Ki-67表達陽性與淋巴結(jié)轉(zhuǎn)移、TNM分期有關(guān)(均P0.05),但與患者腫瘤大小、年齡、組織學分級、絕經(jīng)狀態(tài)無關(guān)(均P0.05);生存曲線顯示TNBC組織中Ki-67陰性表達患者總體生存率顯著高于陽性者(P0.05)。3.TNBC、NTNBC中E-cadherin陽性表達率分別為26.9%、48.1%,TNBC組織中E-cadherin陽性表達率低于NTNBC組織(χ2=4.964,P=0.026);在TNBC組織中,E-cadherin表達陽性與腫瘤大小、淋巴結(jié)轉(zhuǎn)移、TNM分期有關(guān)(均P0.05),但與患者組織學分級、年齡、絕經(jīng)狀態(tài)無關(guān)(均P0.05);生存曲線顯示TNBC組織中E-cadherin陽性表達患者總體生存率顯著高于陰性者(P0.05)。4.生存曲線顯示在TNBC組織中p53、Ki-67陰性及E-cadherin陽性共表達患者的總體生存率顯著高于p53、Ki-67陽性及E-cadherin陰性共表達患者(P0.05)。5.在TNBC組織中,p53、Ki-67陽性表達呈正相關(guān)(r=0.388,P=0.004),p53、E-cadherin陽性表達呈負相關(guān)(r=-0.686,P=0.000),Ki-67、E-cadherin陽性表達呈負相關(guān)(r=-0.584,P=0.000)。6.Cox回歸分析單因素顯示,腫瘤大小、TNM分期、淋巴結(jié)轉(zhuǎn)移、p53、Ki-67及E-cadherin表達是影響三陰性乳腺癌患者總體生存率的顯著因素(均P0.05)。Cox回歸分析多因素顯示,p53、Ki-67及E-cadherin表達、淋巴結(jié)轉(zhuǎn)移是影響三陰性乳腺癌患者總體生存率的獨立預(yù)后因素(均P0.05)。結(jié)論:1.p53、Ki-67在三陰性乳腺癌組織中高表達,其陽性表達者預(yù)后差;E-cadherin在三陰性乳腺癌組織中低表達,其陰性表達者預(yù)后差。2.p53、Ki-67及E-cadherin可能參與三陰性乳腺癌的發(fā)生、發(fā)展及浸潤、轉(zhuǎn)移;聯(lián)合檢測p53、Ki-67及E-cadherin在三陰性乳腺癌中的表達可為患者提供分子治療的新靶點。
[Abstract]:Objective: to detect the expression of p53 Ki-67 and E-cadherin protein in (triple negative breast cancer,TNBC, non-triple-negative breast cancer (non-triple negative breast cancer,NTNBC), and to explore the relationship between the three markers and the clinicopathological features of TNBC. And the correlation between the expression of three proteins. The relationship between the expression of these three proteins and the prognosis of TNBC patients was analyzed. Methods: the expression of p53 Ki-67 and E-cadherin protein were detected by immunohistochemical staining in 52 cases of TNBC,52 with NTNBC. The relationship between the expression of p53 Ki-67 and the prognosis of TNBC was analyzed. Results: 1. The positive expression rate of p53 in TNBC was 67.3 and 44.2, respectively, which was higher than that in NTNBC (蠂 2 = 5.613). In TNBC, p53 positive expression was related to histological grade, tumor size and TNM stage (P0.05), but not to lymph node metastasis, age and menopausal status (P0.05). Survival curve showed that the overall survival rate of patients with p53 negative expression in TNBC was significantly higher than that of positive patients (P0.05). 2. The positive expression rate of Ki-67 in TNBCnTBC was 80.8% and 61.5%, respectively. The positive expression rate of Ki-67 in TNBC was higher than that in NTNBC (蠂 2 + 4.685% P0.030). In TNBC, the positive expression of Ki-67 was related to lymph node metastasis and TNM stage (P0.05), but not to tumor size, age, histological grade and menopausal status (P0.05). Survival curve showed that the overall survival rate of patients with negative expression of Ki-67 in TNBC was significantly higher than that of patients with positive expression (P0.05). 3. The positive expression rate of E-cadherin in NTNBC was 26.9% and 48.1%, respectively. The positive expression rate of E-cadherin in TNBC was lower than that in NTNBC (蠂 2 / 4.964). In TNBC, the positive expression of E-cadherin was related to tumor size, lymph node metastasis and TNM stage (P0.05), but not related to histological grade, age and menopausal status (P0.05). Survival curve showed that the overall survival rate of E-cadherin positive expression patients in TNBC was significantly higher than that of negative patients (P0.05). Survival curve showed that the overall survival rate of patients with p53 Ki-67 and E-cadherin positive co-expression in TNBC was significantly higher than that in p53 Ki-67 positive and E-cadherin negative co-expression (P0.05). In TNBC, the positive expression of p53 Ki-67 was positively correlated with that of p538, E-cadherin (r-0.686) and Ki-67,E-cadherin (r-0.584), and the expression of E-cadherin was negatively correlated with that of p53- 0.686, and that of Ki-67,E-cadherin was negatively correlated with that of p53-p538, E-cadherin and Ki-67,E-cadherin (r-0.584, r = 0.584), respectively. 6.Cox regression analysis showed that the tumor size, TNM stage, lymph node metastasis, p53, p53, The expression of Ki-67 and E-cadherin was a significant factor influencing the overall survival rate of patients with triple-negative breast cancer (P0.05). Cox regression analysis showed that the expression of p53 Ki-67 and E-cadherin was significant in patients with breast cancer. Lymph node metastasis was an independent prognostic factor for the overall survival rate of triple negative breast cancer patients (P0.05). Conclusion: 1. The expression of p53 Ki-67 is high in tri-negative breast cancer, and the prognosis of the patients with positive expression is poor; The prognosis of patients with low expression of E-cadherin in tri-negative breast cancer is poor. 2.p53 Ki-67 and E-cadherin may be involved in the occurrence, development, invasion and metastasis of tri-negative breast cancer. Combined detection of p53 Ki-67 and E-cadherin in tri-negative breast cancer may provide a new target for molecular therapy.
【學位授予單位】：江蘇大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R737.9

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