CAJ | 학술논문

目的：探讨 Her2阳性乳腺浸润性导管癌组织中 TopⅡα蛋白和 Top2A 基因表达的相关性及二者与乳腺癌临床病理特征的关系和临床意义。方法应用免疫组化法(IHC)检测64例乳腺浸润性导管癌组织 TopⅡα蛋白表达；应用 TaqMan 探针法荧光定量 Real-time PCR(逆转录聚合酶链式扩增反应)检测64例乳腺浸润性导管癌及配对癌旁正常组织中 Top2A 基因的相对表达。结果64例乳腺癌组织中 Top2A mRNA 平均相对表达水平为癌旁组织的2.56倍,差异有统计学意义(χ2=1.357,P =0.038)；64例乳腺浸润性导管癌中,TopⅡα蛋白Ⅰ级25例(39.06%),Ⅱ级21例(32.81%),Ш级18例(28.13%)；Top2A 基因表达低表达23例(35.94%),高表达41例(64.06%)。Top2A 基因表达与 TopⅡα蛋白表达比较(χ2=0.993,P =0.609),两者无显著相关性。Top2A 基因表达与患者的年龄、绝经情况、组织学分级及 AJCC 分期无相关性(χ2=0.021,0.049,1.593,0.159,P >0.05)；而与有无腋窝淋巴结相关(χ2=6.155,P =0.013)；TopⅡα蛋白表达与患者的年龄、绝经情况、组织学分级及 AJCC 分期均无相关性(χ2=0.248,4.416,0.150,0.279,P >0.05),而与有无腋窝淋巴结转移相关(χ2=10.192,P =0.006)。结论乳腺癌 Top2A基因表达和 TopⅡα蛋白的表达无相关性,且两者均与乳腺癌有无腋窝淋巴结转移相关；临床上蛋白的检测更为经济,且适用范围更为广泛。故临床上 TopⅡα蛋白的检测更适用于对蒽环类化疗药物应用的评价。
목적：탐토 Her2양성유선침윤성도관암조직중 TopⅡα단백화 Top2A 기인표체적상관성급이자여유선암림상병리특정적관계화림상의의。방법응용면역조화법(IHC)검측64례유선침윤성도관암조직 TopⅡα단백표체；응용 TaqMan 탐침법형광정량 Real-time PCR(역전록취합매련식확증반응)검측64례유선침윤성도관암급배대암방정상조직중 Top2A 기인적상대표체。결과64례유선암조직중 Top2A mRNA 평균상대표체수평위암방조직적2.56배,차이유통계학의의(χ2=1.357,P =0.038)；64례유선침윤성도관암중,TopⅡα단백Ⅰ급25례(39.06%),Ⅱ급21례(32.81%),Ш급18례(28.13%)；Top2A 기인표체저표체23례(35.94%),고표체41례(64.06%)。Top2A 기인표체여 TopⅡα단백표체비교(χ2=0.993,P =0.609),량자무현저상관성。Top2A 기인표체여환자적년령、절경정황、조직학분급급 AJCC 분기무상관성(χ2=0.021,0.049,1.593,0.159,P >0.05)；이여유무액와림파결상관(χ2=6.155,P =0.013)；TopⅡα단백표체여환자적년령、절경정황、조직학분급급 AJCC 분기균무상관성(χ2=0.248,4.416,0.150,0.279,P >0.05),이여유무액와림파결전이상관(χ2=10.192,P =0.006)。결론유선암 Top2A기인표체화 TopⅡα단백적표체무상관성,차량자균여유선암유무액와림파결전이상관；림상상단백적검측경위경제,차괄용범위경위엄범。고림상상 TopⅡα단백적검측경괄용우대은배류화료약물응용적평개。
Objective To investigate the correlation of TopⅡαprotein expression with Top2A gene expression in Her2 positive breast invasive ductal carcinoma,and their clinical significances. Methods Real-time RT-PCR(Taqman)and immunohistochemistry(IHC)were used to explore the expression of Top2A gene and TopⅡαprotein,respectively.Results Top2A mRNA relative expression level in carcinoma tissues was 2.56 times of adjacent tissues,the difference was statis-tically significant(χ2 =1.357,P =0.038);In 64 breast invasive ductal carcinoma patients,there were 25 patients with TopⅡαprotein Ⅰ level(39.06%),21 patients with TopⅡαprotein Ⅱ lev-el(32.81%),18 patients with TopⅡα protein Ш level(28.13%),41 patients with Top2A gene over-expression (64.06%),23 patients with Top2A gene low-expression(35.94%);Top2A gene expression was no significantly correlated with Top Ⅱα protein expression (χ2 = 0.993,P =0.609);TopⅡαprotein expression and Top2A gene aberration had no correlation with the age, menopause condition,histological grade and clinical stage of breast invasive ductal carcinoma(χ2=0.248,4.41 6,0.150,0.279,0.021,0.049.1.593,0.159,P >0.05),which had obvious correla-tion with the axillary lymph node metastases(χ2 =10.1 92,6.155,P =0.006,0.013).Conclusion In breast invasive ductal carcinoma,no correlation was found between TopⅡα protein expres-sion and Top2A gene expression,which were both correlated with the axillary lymph node metas-tases.In clinic,the detection of Top Ⅱα protein expression using immunohistochemical (IHC) method was more suitable for the evaluation of clinical efficacy of anthracycline-based regimen.