【摘要】 目的:分析人乳腺癌患者预后相关危险因素,明确不同因素在影响乳腺癌患者预后中的作用,阐述Clusterin在人乳腺癌组织中表达的临床意义。方法:收集1993~1994年临床预后资料完整的手术切除乳腺癌石蜡包埋组织158例,癌旁组织31例,制作成组织芯片进行Clusterin免疫组化染色,计算染色指数,对影响乳腺癌患者生存预后相关因素进行COX风险比例模型分析和生存分析,Clusterin表达与患者预后、淋巴结转移、肿瘤大小、病理类型和复发之间的相关关系。结果:COX风险比例模型分析结果显示,淋巴结转移和肿瘤大小是影响患者预后最危险的两种因素,B值分别为-0.494和0.142,P值分别为0.001和0.009;生存分析结果显示,Clusterin阳性表达、淋巴结转移和术后化疗6次以下(不包括6次)均明显差于Clusterin阴性表达(χ2=14.085,P=0.000)、无淋巴结转移(χ2=21.458,P=0.000)和术后化疗>6次(χ2=4.442,P=0.035);相关分析结果显示,Clusterin染色指数大小和肿瘤大小具有正相关关系,r=0.249,P=0.002,肿瘤细胞Clusterin表达明显高于癌旁正常乳腺上皮细胞(t=3.131,P=0.003),有淋巴结转移的肿瘤细胞Clusterin表达染色指数明显高于无淋巴结转移肿瘤,t=7.152,P=0.000。结论:淋巴结转移和肿瘤大小影响患者生存预后。作为一种凋亡抑制蛋白,Clusterin与乳腺癌的发生和转移有关。更多还原

【Abstract】 OBJECTIVE: To investigate the significance of clusterin (CLU) expression as a risk factor for breast cancer through tissue microarray technology and univariate analysis of overall survival. METHODS: Formalin-fixed, paraffin-embedded tissues from 158 cases of breast cancer and 31 cases of normal adjacent tissues assembled into a tissue microarray. Cytoplasmic CLU expression in tumor tissues was measured by immunochemistry. Survival analysis was used to investigate the relationship between CLU expression and prognosis, tumor volume, pathological classification and recurrence. RESULTS: The survival time of patients with CLU expression, lymph node metastasis and limited post-surgery chemotherapy (<6 cycles of treatment) was significantly shorter than that of patients with no detectable CLU expression (χ2=14.085,P=0.000), without lymph node metastasis (χ2=21.458,P=0.000) and more comprehensive post-surgery chemotherapy (≥6 cycles of treatment),χ2=4.442,P=0.035. CLU expression in tumor cells was higher than that in normal adjacent breast epithelial cells, t=3.131, P=0.03. The CLU expression staining coefficient of cancer tissues with lymph node metastasis was higher than that of ones without lymph node metastasis, t=7.152, P=0.000. CONCLUSION: Cytoplasmic CLU expression is a prognosis factor for human breast cancer.更多还原