【摘要】 目的研究雌激素受体(ER)和孕激素受体(PR)阳性乳腺癌孕激素受体亚型(PR-A、PR-B)的表达,探讨PR-A、PR-B及其比值(PR-A/PR-B,A/B)与表皮生长因子受体-2(C-erbB-2,Her-2/neu)表达的关系及对无病生存期的影响。方法选取该科2001年3月～2003年10月手术治疗ER、PR阳性乳腺癌65例,癌组织标本采用免疫组织化学SP法检测PR-A、PR-B表达状态,半定量法判定结果,运用SPSS13.0统计软件包及χ2检验进行结果处理,Kaplan-Meier法描述生存曲线。结果PR-A、PR-B阳性表达物位于细胞核中,细胞质及细胞膜无表达;乳腺癌孕激素受体亚型PR-A阳性表达占90.77%(59/65)、PR-B占58.46%(38/65)(P<0.05)。59例PR-A阳性表达乳腺癌中,C-erbB-2阳性48例(81.36%),阴性11例(18.64%)(P<0.01);39例PR-A/PR-B(A/B)值>1的患者中,C-erbB-2阳性33例(84.62%),阴性6例(15.38%)(P<0.05)。在C-erbB-2阳性表达乳腺癌中,A/B值>1的患者无病生存期明显低于A/B值≤1的患者(P<0.05),而C-erbB-2阴性表达时两组的无病生存期差异无显著性(P>0.05)。结论在雌、孕激素受体阳性乳腺癌中,孕激素受体亚型PR-A表达高于PR-B表达,且A/B值增高(>1)。在C-berB-2阳性表达的乳腺癌中,A/B值>1时临床预后差,预示对三苯氧胺治疗不敏感。更多还原

【Abstract】 【Objective】To study the expression of PR-A and PR-B in breast cancers with positive pregesterone and estrogen receptor and explore the correlation between the expression of C-erbB-2(Her-2/neu) and PR-A and PR-B as well as their ratio,the influence of PR-A and PR-B ratio on the progenosis of expression of Her-2/neu is also discussed in breast cancers.【Methods】65 cases of paraffin fixing samples of breast cancer with ER,PR posi-tive and follow-up dates was collected in our mammary department between March 2001 and October 2003.The ex-pression of PR-A and PR-B was detected by IHC-SP method.Statistical analysis was performed using SPSS soft-ware version 13.0.【Results】All the positive staining of PR-A and PR-B is located in the cell nucleus,not in the cell membrane and cytoplasm.Among the 65 patients of ER and PR positive breast cancer,PR-A was positive ex-presion in 90.77%(59/65),which was higher than PR-B 58.46%(38/65)(P <0.05).In the 59 patients of PR-A posi-tive expression,the 48(81.36%) patients of C-erbB-2 positive express was higher than 11(18.64%) patients of neg-ative(P <0.01).In the 39 cases of the ratio of PR-A and PR-B >1,the 33(84.62%) cases of C-erbB-2 positive ex-pression was higher,6(15.38%) cases negative(P <0.05).There is significant difference between the ratio of PR-A and PR-B and disease free survival(DFS) in the breast cancer with the positive expression of C-erbB-2.The DFS was lower in breast cancer patients with high ratio of PR-A and PR-B(>1) than that with low ratio of two isoforms(≤1),which is significantly different(P <0.05).【Conclusion】The expression level of PR-A is higher than PR-B and the ratio of PR-A and PR-B is increasing in patients with ER、PR positive breast cancer.The higher ratio of PR-A and PR-B may indicate poorer response to Tamoxifen endocrine therapy in the breast cancer patients with C-erbB-2 positive expression.更多还原