【摘要】 目的探求可能诱导局部高雌激素浓度的乳腺癌芳香化酶表达对淋巴结阴性乳腺癌预后的影响。方法应用免疫组织化学方法检测244例原发性淋巴结阴性乳腺癌组织内的芳香化酶蛋白表达,并作单因素及多因素生存分析,研究芳香化酶表达的预后意义。结果134(54.9%)例乳腺癌组织内高表达芳香化酶,单因素生存分析发现肿瘤的大小、组织学分级和术后三苯氧胺辅助治疗是影响本组患者无瘤生存的预后因素(P<0.05),芳香化酶的状态对本组患者的无瘤生存率的影响具有临界统计学意义(P=0.058),比例风险Cox模型的多因素生存分析提示原发肿瘤大小、组织学分级和术后三苯氧胺辅助治疗是影响本组患者无瘤生存的独立预后因素,而芳香化酶状态对预后的影响呈现时间依赖性特点(P<0.05),时间依赖性非比例风险模型的多因素生存分析提示芳香化酶是本组患者无瘤生存的独立的预后因素(P<0.05)。结论芳香化酶可能是淋巴结阴性乳腺癌患者的预后因素,高表达芳香化酶患者的复发转移的相对风险高,但其程度随时间的改变而改变,这对于针对性制订治疗和随访计划具有一定的临床意义。更多还原

【Abstract】 Purpose To explore whether aromatase expression,which may induce local high concentration of estrogen,was related to prognosis in node metastasis negative breast cancer patients. Methods By using immunohistochemistry staining the protein expression of aromatase in 244 patients with primary breast cancers was detected,univariate and multivariate survival analysis were used to study the role of aromatase as one of prognostic factors. Results Totally 134(54.9%) cases were detected with high expression of aromatase in their cancer tissues.Univariate survival analysis indicated that tumor size,histological grade and adjuvant tamoxifen treatment were prognostic factors for disease free survival(P<0.05),aromatase was related to decreased disease free survival with margin significance(P=0.058).Multivariate survival analysis with proportional hazard Cox model showed that tumor size,histological grade and adjuvant tamoxifen treatment were dependent prognostic factors for disease free survival(P<0.05),relapse hazard related to aromatase expression was time dependent (P<0.05).Multivariate survival analysis with non-proportional hazard Cox model showed that aromatase was time dependent prognostic factor for disease free survival. Conclusions Aromatase may be a prognostic factor in node negative breast cancer patients,the relapse hazard ratios of aromatase positive patients change across time,this may be helpful to make individual treatment regiment and follow-up plan in breast cancer patients.更多还原