【作者】 原银萍；

【导师】 王绪洲；

【作者基本信息】 山东大学 ， 病理学与病理生理学， 2005， 硕士

【摘要】 目的:探讨p16、cyclinD1蛋白及基因在腋淋巴结阴性的乳腺癌中的表达及其对患者预后的意义。 方法:对65例资料完整的腋淋巴结阴性的乳腺癌存档石蜡组织标本进行重新切片,应用免疫组织化学方法检测乳腺癌组织中p16、cyclinD1的蛋白表达情况,并对免疫组化结果异常的标本进行半定量PCR扩增,以期发现其基因的异常改变。将所得实验结果结合随访资料,分析p16、cyclinD1的蛋白表达及基因异常与腋淋巴结阴性的乳腺癌的临床病理因素、复发转移以及预后之间的关系。 结果:p16蛋白的表达与患者的年龄、肿瘤大小、组织学类型、ER表达情况、月经状况等临床病理因素均无关(P>0.05)。p16基因缺失与患者的年龄、肿瘤大小、组织学类型、ER表达情况、月经状况等因素均无关(P>0.05)。cyclinD1蛋白的阳性表达与患者的年龄、肿瘤大小、组织学类型、月经状况等因素均无关(P>0.05),而与ER表达情况成正相关(P<0.05)。cyclinD1蛋白的过表达与患者的年龄、肿瘤大小、组织学类型、月经状况等因素均无关(P>0.05),而与ER表达情况成正相关(P<0.05)。cyclinD1基因扩增与患者的年龄、肿瘤大小、组织学类型、月经状况等因素均无关(P>0.05),而与ER表达情况成正相关(P<0.05)。p16蛋白的阳性表达、cyclinD1蛋白的阳性表达、cyclinD1蛋白的过表达及cyclinD1基因扩增与乳腺癌术后复发转移及相关死亡具有统计学相关性(P<0.05,P<0.01)。单因素生存分析显示,p16蛋白的阳性表达、更多还原

【Abstract】 Object: To study the expression of p16 and cyclinD1 in axillary-node negative breast carcinoma and analyze their relationship with metastasis and prognosis .Method: This study include 65 patients who underwent curative resection of breast carcinoma with complete 5 years folloe-up or till death. We examined the expression of p16 and cyclinD using immunohistochemistry method and PCR ( polymerase chain reaction) in the specimens of the tumor. Furthermore, we analyze the relationship between the expression of these markers and the cinicpathological parameters and the metastasis and prognosis.Result:The expression of p16 and the deletion of the p16 gene in axillary-node negative breast carcinoma had no correlation with the age, the volume of the tumor, histological type of the tumor, the expression of ER, menstrual history (P>0.05) . The expression of cyclinD1 and its overexpression and the amplification of the cyclinD1 gene in axillary-node negative breast carcinoma had no correlation with the age, the volume of the tumor, histological type of the tumor and menstrualhistoryC P>0.05) , but had correlation with the expression of ER( P<0.05 ). The expression of pl6 , cyclinDl, the overexpression of cyclinDl and the amplification of the cyclinDl gene had significant correlation with the relapse and metastasis of the axillary-node negative breast carcinoma( P<0.05, P<0.01 ) . Kaplan-Meier estimates revealed that the survival rate was correlated with the expression of pl6 , cyclinDl, the overexpression of cyclinDl and the amplification of the cyclinDl gene. However, Cox proportional hazards analysis showed that only the expression of pi6 retained significant independently in prospecting prognosis ( P<0.05 ) . And the expression of pl6 was negatively associated with that of cyclinDl(P<0.01); the expression of cyclinDl, the overexpression of cyclinDl and the amplification of the cyclinDl gene were positively associated with that of ER (P<0.05) .Conclusion:The results suggests that the expression of pl6 and cyclinDl, the overexpression of cyclinDl and the amplification of the cyclinDl gene in tumor tissue, is associated with the tumor progression,metastasis and poor prognosis of patients in in axillary-node negative breast carcinomao PI6 can be considefed as the independent parameters in predicating the metastasis and prognosis in in axillary-node negative breast carcinoma. P16 and cyclinDl may have a synergistic action in the process of metastasis. CyclinDl can be used as an assistant indicator to predict the prognosis of in axillary-node negative breast carcinoma.更多还原