【作者】 刘从云；

【导师】 吴强； 张瑰红；

【作者基本信息】 安徽医科大学 ， 病理学与病理生理学， 2008， 硕士

【摘要】 背景:乳腺癌是女性最常见的恶性肿瘤之一,据调查统计表明,乳腺癌的发病率每年以4﹪的幅度递增,发病率居女性恶性肿瘤之首,严重威胁妇女健康。从分子生物学角度研究乳腺癌预后的影响因素,将有助于我们进一步了解乳腺癌的生物学行为。Endocan是近年来发现的新颖的内皮细胞特异性分子,经研究发现其在肾细胞癌、恶性淋巴瘤、子宫内膜癌、直肠腺癌等肿瘤组织中均有表达增强,而在癌旁的正常组织中均无表达或弱表达,Endocan在乳腺癌组织中的分布及其对乳腺癌的生物学意义目前国内外尚未见报道,值得进一步研究。目的:通过对乳腺癌组织中Endocan mRNA及其蛋白的检测,结合临床病理资料和所有病例的5年以上随访结果,分析Endocan的表达与乳腺癌临床病例资料的关系及其对乳腺癌预后的意义。方法:应用组织芯片平台,采用原位分子杂交和免疫组织化学技术检测108例随访5年以上的乳腺癌组织中Endocan mRNA及其蛋白表达,探讨Endocan对乳腺癌生物学行为的影响意义。结果:(1) Endocan mRNA及其蛋白在乳腺癌组织的癌细胞和血管内皮细胞表达,主要定位于癌细胞和血管内皮细胞的细胞质,少量定位于细胞核,阳性率分别为42.6%和88.0%,而在癌旁的正常组织中仅部分微血管内皮细胞见有较弱表达,上皮细胞中未见阳性染色。(2) Endocan mRNA和蛋白表达呈正相关(r=0.193,P<0.05),但Endocan mRNA的染色强度较Endocan蛋白的染色强度弱。(3)存活5年以上者Endocan蛋白的高表达率为74.4%,明显高于死亡组(44.4%),两者呈负相关,肿瘤直径<2cm者Endocan高表达率(41.6%)低于肿瘤直径2～5cm者(76.9%)。(4) 50岁以上年龄组Endocan mRNA的表达率为63.6%,明显高于50以下年龄组(28.1%),差异存在显著性(P<0.01)。(5) Endocan在乳腺癌组织中的表达与组织学分级、ERα、PR、临床分期、淋巴结状况、患者年龄无关。结论:(1)乳腺癌组织中存在Endocan的表达异常,提示Endocan与乳腺癌关系密切;(2)Endocan可作为乳腺癌预后的分子标记;更多还原

【Abstract】 Background: Breast carcinoma is one of the most common malignant tumors for females,which increases at the rate of 4% every year and ranks first in female malignant tumors and greatly threatens females’health. It is helpful to elucidate the influence factors of breast carcinoma prognosis at molecular level in order to further understanding the biological behavior of breast carcinoma. Endocan, which is also called endothelial cell specific molecule 1 and was found in recent years, is a special endothelial cell specific molecule. Studies have shown that the expression of endocan was upregulated in some tumor tissues, such as renal cell carcinoma, malignant lymphoma, endometrial carcinoma, colorectal carcinoma and others. The distributions of endocan in the breast carcinoma tissue and its biological significance to breast carcinoma have not yet known, so it is worth to be further studied.Objective: To analysis the expression of endocan mRNA and its protein in breast carcinoma tissues and its relationship to the clinicopathological features, and its prognosic significance.Methods: Tumor tissue chips of breast carcinoma from 108 female patients were constructed. The expression of endocan mRNA and its protein was detected by in situ hybridization and immunohistochemistry respectively. Patients were followed up via mail or telephone, the follow up period was 5 years.Results: (1) Positive stainings for both endocan mRNA and its protein were evident in cancer tissues, with positive rates 42.6% and 88.0%, which were mainly located in the carcinoma cells of cancer tissue and blood vessel endothelia, and in nuclei in a few cases. In contrast, Positive stainings for both endocan mRNA and its protein in breast tissues adjacent to the carcinoma were found only in some endothelial cells, no positive stainings were found in breast epithelia. (2) Positive relations were found between the expression of endocan mRNA and that of its protein(r=0.220, P<0.05). (3) High level expression of the protein in patients who survived for more than 5 years is 74.4%, which was higher than that in the death group (44.4%), and expression of over five years survival is negative correlation to expression of death. The high expression rate of protein in tumors less than 2cm in diameter was 41.6%, which is lower than that of the tumors between 2cm and 5cm in diameter(s76.9%). (4) The mRNA expression of more than 50 years old group is 63.6%, which is obvious higher than that of less than 50 years old, and the difference is apparent(P<0.01). (5) There are no relationship between protein expression and histological grading, ERα, PR, TNM stage, lymphonode status and patient age.Conclusion: (1) Abnormal expression exists in breast carcinoma tissue, indicating endocan has close relation to breast carcinoma. (2) Endocan can be treated as the molecule marker of breast carcinoma prognosis.更多还原