CAJ | 학술논문

目的研究受体三阴性乳腺癌组织中基底细胞角蛋白(CK5/6和CKl7)的表达情况,探讨其与患者临床病理特征及预后之间的关系.方法 2000年1月至2002年12月在复旦大学附属肿瘤医院接受手术治疗,有完整随访资料且免疫组织化学检测为受体三阴性的乳腺癌患者112例,将112例原发灶石蜡切片用EnVision二步法进行CK5/6和CK17免疫组织化学染色,检测CK5/6和CK17的表达.结果全组患者的5年无复发生存率为73.2%(82/112).CK5/6和CK17均为阳性的患者占21.4%(24/112),CK5/6和(或)CK17阳性(即CKs阳性)者占46.4%(52/112).CK5/6、CK17和CKs阳性患者的5年无复发生存率均低于其对应的阴性患者(P=0.020,P=0.032,P=0.003);CK5/6和CKs阳性患者的5年总生存率亦低于其对应的阴性患者(P=0.027,P=0.015).CKs阳性患者与CK5/6和CK17阴性(即CKs阴性)患者比较,组织学分级为Ⅲ级的患者所占的比例以及腋窝淋巴结转移之间的差异有统计学意义(P=0.030,P=0.044).多因素分析显示,组织学分级、病理分期以及CK5/6的表达均为5年无复发生存率和总生存率的独立影响因素,月经状态为5年无复发生存率的独立影响因素.结论 CK5/6和CK17的表达与肿瘤的组织学分级以及腋窝淋巴结的转移状态相关,且阳性表达患者的预后较差.
목적 연구수체삼음성유선암조직중기저세포각단백(CK5/6화CKl7)적표체정황,탐토기여환자림상병리특정급예후지간적관계.방법 2000년1월지2002년12월재복단대학부속종류의원접수수술치료,유완정수방자료차면역조직화학검측위수체삼음성적유선암환자112례,장112례원발조석사절편용EnVision이보법진행CK5/6화CK17면역조직화학염색,검측CK5/6화CK17적표체.결과 전조환자적5년무복발생존솔위73.2%(82/112).CK5/6화CK17균위양성적환자점21.4%(24/112),CK5/6화(혹)CK17양성(즉CKs양성)자점46.4%(52/112).CK5/6、CK17화CKs양성환자적5년무복발생존솔균저우기대응적음성환자(P=0.020,P=0.032,P=0.003);CK5/6화CKs양성환자적5년총생존솔역저우기대응적음성환자(P=0.027,P=0.015).CKs양성환자여CK5/6화CK17음성(즉CKs음성)환자비교,조직학분급위Ⅲ급적환자소점적비례이급액와림파결전이지간적차이유통계학의의(P=0.030,P=0.044).다인소분석현시,조직학분급、병리분기이급CK5/6적표체균위5년무복발생존솔화총생존솔적독립영향인소,월경상태위5년무복발생존솔적독립영향인소.결론 CK5/6화CK17적표체여종류적조직학분급이급액와림파결적전이상태상관,차양성표체환자적예후교차.
Objective To investigate the correlation of CK5/6 and CK17 expression with clinical outcome in patients with triple-negative[ER(-),PR(-),Her-2(-)]breast cancer.Methods 112 patients with breast cancer treated by surgery between 2000 and 2002 were included in this study.All cases were immunohistochemically proven to be triple-negative.Sampies of formalin-fixed and paraffin-embedded surgical specimens were obtained for immunohistological examination for CK5/6 and CK17 expression.The correlation of the gene expression with clinicopathological features and outcome of the patients was analyzed.Results Of the 112 triple-negative patients,five-year disease-free survival rate was 73.2%(82/112).The positive rate of both CK5/6 and CK17 was 21.4%(24/112),either CK5/6 or CK17 positive waa 46.4%(52/112).It was shown by Kaplan-Meier curve that positive CK5/6.CK17 or CKs(CK5/6 or CK17 positive)was correlated with poor five-year disease-free survival(P=0.020,P=0.032,P=0.003);and positive staining of CK5/6 or CKs was correlated with poor five-year overall survival(P=0.027,P=0.015).Of the 91 patients with invasive ductal carcinoma.a correlation of CK5/6 or CK17 positive staining with high grade differentiation was observed(P=0.030),and with axillary lymph node metastasis was also noticed(P=0.044).Multivariate analysis by Cox regression showed that differentiation grade,pathological stage and expression of CK5/6 were factors affecting both the disease-free-survival and overall-survival.while menopausal status was an independent factor affecting the disease-free-survival.Conclusion Positive expression of CK5/6 or CK17 in patients with triple-negative breast cancer is correlated with poor prognosis,high grade differentiation and axillary lymph node metastasis.