【摘要】 目的:探讨nm23基因表达对乳腺癌患者预后的影响。方法:选择哈尔滨医科大学附属第二医院普外科1997-06/1998-12行根治性治疗的乳腺癌患者60例。均为女性,年龄2663岁。有腋淋巴结转移30例,无腋淋巴结转移30例。依国际抗癌协会临床分期标准,Ⅰ期30例,Ⅱ期16例,Ⅲ期14例,无Ⅳ期患者。随机选取同期乳腺囊性增生症患者20例作对照。应用免疫组织化学SP法检测两组患者标本中nm23基因的表达情况,观察nm23阳性表达与临床病理参数、远处转移及生存率的关系。nm23基因表达以细胞浆呈棕黄色为阳性。结果:乳腺癌患者60例,乳腺囊性增生症患者20例,均进入结果分析。①nm23基因在乳腺癌及乳腺囊性增生症中的阳性表达:乳腺癌中nm23阳性表达显著高于乳腺囊性增生症中nm23阳性表达(60.0%,30.0%,P<0.05)。②nm23阳性表达与临床病理参数的关系:临床Ⅰ～Ⅱ期患者nm23阳性表达率著性高于Ⅲ期患者(67.4%,35.7%,P<0.05);无淋巴结转移者nm23的阳性表达率显著高于有淋巴结转移者(86.7%,33.3%,P<0.05);雌激素受体(+)者nm23的阳性表达率显著高于雌激素受体(-)者(72.7%,25.0%,P<0.05);孕激素受体(+)者nm23的阳性表达率显著高于孕激素受体(-)者(75.0%,30.0%,P<0.05)。③nm23阳性表达与远处转移及生存率的关系:无远处转移者nm23的阳性表达率显著高于有远处转移者(73.4%,14.3%,P<0.05);nm23阳性表达者5年生存率显著高于nm23阴性表达者(94.4%,50.0%,P<0.05)。结论:检测乳腺癌组织中nm23基因对评价乳腺癌患者的预后和指导临床治疗有重要价值。更多还原

【Abstract】 AIM: To investigate the influence of the expression of nm23 gene on the prognosis in patients with breast cancer. METHODS: Sixty female patients with breast cancer of 26-63 years old, who received radical treatment in the Department of General Surgery, the Second Affiliated Hospital of Harbin Medical University from June 1997 to December 1998, participated in the study, including 30 cases had transfer of axillary lymph node and 30 cases had no transfer of axillary lymph node. According to the clinical staging standard of International Anti-Cancer Association, the patients were classified into 30 cases of stage, 16 cases of stage Ⅱ, 14 cases of stage Ⅲ and none was stage Ⅳ, another 20 patients with breast cystic hyperplasia at the same period were randomly selected as controls. The expression of nm23 gene was detected with immunohistochemical S-P method in both groups, and the associations of the positive expression of nm23 gene with the clinical pathological indexes, distant transfer and survival rate were observed. The buffy cell plasm was taken as the positive expression of nm23 gene. RESULTS: All the 60 patients with breast cancer and 20 patients with breast cystic hyperplasia were involved in the analysis of results. ① The positive expression of nm23 gene in breast cancer and breast cystic hyperplasia: It was significantly higher in breast cancer than in breast cystic hyperplasia (60.0%, 30.0%, P < 0.05). ② Association between the positive expression of nm23 gene and clinical pathological indexes: The positive expression rate of nm23 gene was significantly higher in patients of clinical stages Ⅰ-Ⅱ than in those of stage Ⅲ (67.4%, 35.7%, P < 0.05), significantly higher in patients without transfer of axillary lymph node than in those with transfer of axillary lymph node (86.7%, 33.3%, P <0.05), significantly higher in patients with hormone receptor (+) than in those with hormone receptor (-) (72.7%, 25.0%, P < 0.05), also significantly higher in the patients with progestogen receptor (+) than in those with progestogen receptor (-) (75.0%, 30.0%, P < 0.05). ③ Correlation of the positive expression of nm23 gene with distant transfer and survival rate: The positive expression of nm23 gene was significantly higher in the patients without distant transfer those with distant transfer (73.4%, 14.3%, P < 0.05), and survival rate of 5 years was significantly higher in the patients with positive expression of nm23 gene than in those with negative ones (94.4%, 50.0%, P < 0.05). CONCLUSION: It is the most helpful in evaluating the prognosis of patients with breast cancer and directing clinical treatment to observe the expression of nm23 gene.更多还原