【摘要】 目的研究上皮细胞黏附分子E-钙黏蛋白(E-cadherin)在乳腺癌组织中的表达和临床意义。方法回顾性分析2009年11月至2014年10月在河南科技大学第一附属医院接受改良根治术的303例乳腺癌病例资料,应用免疫组织化学染色法检测癌组织中E-cadherin和HER-2的表达,分析E-cadherin在不同分子分型乳腺癌中的表达特点及与临床病理特征的相关性。计数资料采用χ2检验或Fisher确切概率法,相关性分析采用Pearson相关分析,并用Logistic回归分析影响E-cadherin表达的独立因素。结果 303例乳腺癌组织中E-cadherin和HER-2阳性表达率分别为71.9%(218/303)和16.2%(49/303)。E-cadherin与患者年龄、月经状态、TNM分期及腋窝淋巴结转移有关(χ2=4.854、8.277、8.757、10.614,P均<0.050),HER-2表达与组织学分级有关(χ2=0.002,P<0.050)。Pearson相关分析显示,乳腺癌组织中E-cadherin与HER-2、ER及PR呈正相关(r=0.135、0.206、0.135,P=0.019、0.000、0.019),而与Ki67表达强度无关;HER-2与ER、PR呈负相关(r=-0.160、-0.118,P=0.005、0.040),与Ki67表达呈正相关(r=0.228,P=0.000)。Logistic回归多因素分析显示年龄、肿瘤直径、TNM分期为影响E-cadherin表达的临床病理因素,而HER-2和ER是影响E-cadherin表达的分子病理因素。E-cadherin阳性表达率在不同分子分型间差异有统计学意义(χ2=24.816,P=0.000),而三阴性乳腺癌(TNBC)为51.3%,显著低于luminal B型及HER-2过表达型(P均<0.008)。结论 E-cadherin表达缺失与TNBC更容易发生侵袭转移密切相关,而HER-2和ER可能参与E-cadherin表达缺失的调控机制。更多还原

【Abstract】 Objective To study the expression of epithelial cellular adhesion molecule( E-cadherin)in different molecular subtypes of breast cancer and its clinical significance. Methods A total of 303 cases of breast cancer treated with modified radical mastectomy were retrospectively collected in the First Affiliated Hospital,Henan University of Science and Technology from November 2009 to October 2014. The expressions of E-cadherin and HER-2 in breast cancer tissues were detected by immunohistochemical staining to analyze the expression pattern of E-cadherin in different molecular subtypes of breast cancer and its association with clinicopathological features of the patients. Numeration data was processed using χ2test or Fisher ’s exact test,correlation analysis was performed using Pearson method,and Logistic regression was used to analyze the independent factors in E-cadherin expression. Results The positive rates of E-cadherin and HER-2 in 303 cases of breast cancer were 71. 9%( 218 / 303) and 16. 2%( 49 / 303) respectively. E-cadherin expression was correlated with patients ’age,menopausal status,TNM staging,and axillary lymph node metastasis( χ2=4. 854,8. 277,8. 757,10. 614,all P < 0. 050); and HER-2 expression was associated with histological grade( χ2= 0. 002,P < 0. 050). Pearson correlation analysis showed that E-cadherin was positively correlated with HER-2,ER,and PR in breast cancer tissue( r = 0. 135,0. 206,0. 135,P = 0. 019,0. 000,0. 019),and not correlated with Ki67. HER-2 was negatively correlated with ER and PR( r =- 0. 160,- 0. 118,P = 0. 005,0. 040),and positively correlated with Ki67( r = 0. 228,P = 0. 000). Logistic regression showed that patients’ age,tumor size,and TNM staging,clinico pathological and HER-2 and ER were molecular pathological factors influencing E-cadherin expression in breast cancer. There was a significant difference in E-cadherin expression between different molecular subtypes of breast cancer( χ2= 24. 816, P = 0. 000). The positive rate of E-cadherin expression was 51. 3% in triple-negative breast cancer( TNBC),significantly lower than that in luminal B or HER-2-riched( all P<0. 008). Conclusion The deficiency of E-cadherin expression is associated with the biological behaviors of invasion and metastasis in TNBC,while HER-2 and ER may be involved in the regulatory mechanism of E-cadherin expression deficiency.更多还原