摘要
目的 研究 c- Erb B- 2过度表达、流式细胞术 (FCM)DNA倍体和 S期百分比 (SPF)在原发性乳癌中的相关性及其预后价值 ,以期为临床提供指导 .方法 70例乳腺癌组织石蜡包埋切块通过免疫组化 (IHC)检测 c- erb B- 2过度表达情况 .30例新鲜肿瘤组织 ,4 0例石蜡包埋组织切片行 FCMDNA检测 .术后平均随访 6 1.4 (36～ 10 4 ) mo.Spearman等级相关研究 c- erb B- 2同其他因素的相关性 ,Cox回归分析其预后价值 .结果 70例原发性乳癌组织中 ,c- erb B- 2过度表达 2 1例 ,其中浸润性癌 5 5例中 2 0例 (36 .4 % ) ,非浸润性癌15例中 1例 (6 .7% ) .c- erb B- 2和 ER,PR呈强负相关 (P<0 .0 0 0 1) ,与 DNA倍体呈正相关 (P=0 .0 2 1) ,与 SPF呈正相关 (P=0 .0 139) ,与年龄、淋巴结状态、肿瘤分期无明显相关性 ,与 PF间无明显相关 (P=0 .0 6 17) .单因素分析发现c- erb B- 2对无复发生存期 (RFS)和总生存期 (OS)有显著意义(P<0 .0 5 ) ,DNA倍体对 RFS有显著意义 (P<0 .0 5 ) ,对 OS有非常显著意义 (P<0 .0 1) ,SPF对 OS有意义 (P<0 .0 1) ,PF则无论对 RFS还是 OS均无明显意义 .多因素分析发现对 RFS有意义的 3个因素分别为肿瘤大小 (P=0 .0 2 5 ) ,淋巴结状态 (P=0 .0 0 2 )和 PR(P<0 .0 0 1) ;对
AIM To study the influence of proto oncogene c erbB 2 overexpression, DNA ploidy and S phase fraction (SPF) on prognosis of primary breast carcinoma and provide information for clinical practice. METHODS The immunohistochemistry (IHC) for c erbB 2 oncoprotein was performed on formalin fixed paraffin embedded sections of 70 primary breast carcinomas resected after mastectomy and for which a follow up of 36~104 months was available. FCM DNA analysis was performed on fresh tumors of 30 patients and paraffin embedded primary tumors of 40 patients. The relationship between c erbB 2 expression and other prognostic factors were undertaken by Spearman rank correlation test, and the prognostic value was derived from the results of Cox model. RESULTS Of 70 tumors, 21 (30%) showed a positive membrane staining, in which 20 (36.4%) showed a positive in 55 infiltrating tumors and 1 (6.7%) in non infiltrating ones. An association between c erbB 2 and DNA ploidy ( P =0.021) and SPF ( P =0.0139), a significant negative correlation between c erbB 2 and both estrogen and progesterone receptors ( P <0.0001) were observed, no relationships between c erbB 2 and age, tumor size, axillary lymph node status and tumor stage, and a borderline relationship between c erbB 2 and PF ( P =0.0617). In univariate analysis, with respect to relapse free survival (RFS) and overall survival (OS), c erbB 2 was significant for both ( P <0.05), DNA ploidy significant for RFS ( P <0.05) and OS ( P < 0.01 ), and SPF significant for OS ( P <0.05). PF was associated with neither RFS nor OS. In multivariate analysis, the factors retaining independent prognostic significance in the OS analysis were UICC grading ( P <0.001) and DNA ploidy (a borderline P value, P =0.109 to standard α=0.10), and the factors for RFS were tumor size ( P =0.025), lymph node status ( P =0.002) and progesterone receptors ( P < 0.001 ) respectively, but the c erbB 2 membrane staining was not a significant predictor for RFS or OS. CONCLUSION c erbB 2 provides important prognostic information, but it is not an independent prognostic factor. DNA ploidy may have a good prognostic value in comparison with SPF and PF. Stability of c erbB 2 by IHC lays a foundation for its application to clinical practice.
出处
《第四军医大学学报》
CAS
北大核心
2002年第21期1933-1936,共4页
Journal of the Fourth Military Medical University
