中华诊断学电子杂志
中華診斷學電子雜誌
중화진단학전자잡지
Chinese Journal of Diagnostics (Electronic Edition)
2015年
4期
282-287
,共6页
胡东玉%徐芳芳%王全义%赵广章%蒋歆昶
鬍東玉%徐芳芳%王全義%趙廣章%蔣歆昶
호동옥%서방방%왕전의%조엄장%장흠창
乳腺肿瘤%预后%肿瘤浸润
乳腺腫瘤%預後%腫瘤浸潤
유선종류%예후%종류침윤
Breast neoplasms%Prognosis%Neoplasm invasiveness
目的:探讨趋化因子 CXCL12/CXCR4、DNA拓扑异构酶Ⅱα( TopoⅡα)、核因子κB ( NF?κB)在三阴性乳腺癌( TNBC)组织中的表达的意义。方法53例TNBC患者为TNBC组,76例非三阴性乳腺癌( N?TNBC)患者为N?TNBC组。取患者手术切除病灶标本进行免疫组织化学染色,分别检测组织中CXCL12/CXCR4、TopoⅡα、NF-κB蛋白水平。自术后开始随访,记录术后复发、转移、死亡情况,死亡患者以截尾数据统计,存活患者至少随访3年,统计患者复发转移及死亡率,比较各组无病生存时间( DFS)。采用SPSS 17.0统计软件对数据进行分析,组间率以及按不同临床病理指标分组后的比较均采用χ2检验和Fisher精确概率法检验, DFS采用均数±标准差表示,组间比较采用配对样本的t检验。结果 TNBC组≤50岁患者所占比例高、淋巴结转移较早、浸润性导管癌、临床分期以Ⅲ期多见。 TNBC 组 CXCL12、CXCR4、TopoⅡα、NF?κB 阳性细胞比例分别为66.04%、84.91%、69.81%、79.25%,N?TNBC组比例分别为40.79%、51.32%、40.79%、51.32%,TNBC组阳性细胞比例高于N?TNBC组,差异有统计学意义(χ2=7.97,15.51,10.55,10.43;P<0.01)。 TNBC组复发转移率、死亡率、DFS分别为20.75%、28.30%、(24.35±3.50)月,N?TNBC组分别为11.32%、13.16%、(32.02±4.00)月,TNBC组复发转移率、死亡率均高于N?TNBC组,差异有统计学意义(χ2=4.51,4.58;P <0.05), DFS少于N?TNBC组( t =5.29, P<0.05);CXCL12、CXCR4、TopoⅡα、NF?κB阳性表达组复发转移率分别为19.70%、17.86%、19.12%、18.52%,阴性表达组分别为6.35%、4.44%、6.56%、4.17%,阳性表达组均高于阴性表达组(χ2=5.02,4.61,4.43,5.43; P <0.05);阳性表达组死亡率分别为27.27%、25.00%、26.47%、24.69%,阴性表达组分别为11.11%、8.89%、11.48%、10.42%,阳性表达组均高于阴性表达组(χ2=5.39,4.87,4.63,3.93;P <0.05);阳性表达组DFS分别为(23.17±3.30)月、(24.50±3.21)月、(23.51±3.65)月、(25.36±3.65)月,阴性表达组分别为(32.25±3.55)月、(33.00±4.15)月、(35.00±5.10)月、(31.86±4.57)月,阳性表达组均少于阴性表达组( t =5.37,5.80,6.21,5.08;P <0.05)。结论 TNBC患者癌灶组织中CXCL12、CXCR4、TopoⅡα、NF?κB呈高表达状态,且阳性表达者复发转移较早,预后不佳,这可能与其增加肿瘤细胞的侵袭能力、介导淋巴结特异性转移有关。
目的:探討趨化因子 CXCL12/CXCR4、DNA拓撲異構酶Ⅱα( TopoⅡα)、覈因子κB ( NF?κB)在三陰性乳腺癌( TNBC)組織中的錶達的意義。方法53例TNBC患者為TNBC組,76例非三陰性乳腺癌( N?TNBC)患者為N?TNBC組。取患者手術切除病竈標本進行免疫組織化學染色,分彆檢測組織中CXCL12/CXCR4、TopoⅡα、NF-κB蛋白水平。自術後開始隨訪,記錄術後複髮、轉移、死亡情況,死亡患者以截尾數據統計,存活患者至少隨訪3年,統計患者複髮轉移及死亡率,比較各組無病生存時間( DFS)。採用SPSS 17.0統計軟件對數據進行分析,組間率以及按不同臨床病理指標分組後的比較均採用χ2檢驗和Fisher精確概率法檢驗, DFS採用均數±標準差錶示,組間比較採用配對樣本的t檢驗。結果 TNBC組≤50歲患者所佔比例高、淋巴結轉移較早、浸潤性導管癌、臨床分期以Ⅲ期多見。 TNBC 組 CXCL12、CXCR4、TopoⅡα、NF?κB 暘性細胞比例分彆為66.04%、84.91%、69.81%、79.25%,N?TNBC組比例分彆為40.79%、51.32%、40.79%、51.32%,TNBC組暘性細胞比例高于N?TNBC組,差異有統計學意義(χ2=7.97,15.51,10.55,10.43;P<0.01)。 TNBC組複髮轉移率、死亡率、DFS分彆為20.75%、28.30%、(24.35±3.50)月,N?TNBC組分彆為11.32%、13.16%、(32.02±4.00)月,TNBC組複髮轉移率、死亡率均高于N?TNBC組,差異有統計學意義(χ2=4.51,4.58;P <0.05), DFS少于N?TNBC組( t =5.29, P<0.05);CXCL12、CXCR4、TopoⅡα、NF?κB暘性錶達組複髮轉移率分彆為19.70%、17.86%、19.12%、18.52%,陰性錶達組分彆為6.35%、4.44%、6.56%、4.17%,暘性錶達組均高于陰性錶達組(χ2=5.02,4.61,4.43,5.43; P <0.05);暘性錶達組死亡率分彆為27.27%、25.00%、26.47%、24.69%,陰性錶達組分彆為11.11%、8.89%、11.48%、10.42%,暘性錶達組均高于陰性錶達組(χ2=5.39,4.87,4.63,3.93;P <0.05);暘性錶達組DFS分彆為(23.17±3.30)月、(24.50±3.21)月、(23.51±3.65)月、(25.36±3.65)月,陰性錶達組分彆為(32.25±3.55)月、(33.00±4.15)月、(35.00±5.10)月、(31.86±4.57)月,暘性錶達組均少于陰性錶達組( t =5.37,5.80,6.21,5.08;P <0.05)。結論 TNBC患者癌竈組織中CXCL12、CXCR4、TopoⅡα、NF?κB呈高錶達狀態,且暘性錶達者複髮轉移較早,預後不佳,這可能與其增加腫瘤細胞的侵襲能力、介導淋巴結特異性轉移有關。
목적:탐토추화인자 CXCL12/CXCR4、DNA탁복이구매Ⅱα( TopoⅡα)、핵인자κB ( NF?κB)재삼음성유선암( TNBC)조직중적표체적의의。방법53례TNBC환자위TNBC조,76례비삼음성유선암( N?TNBC)환자위N?TNBC조。취환자수술절제병조표본진행면역조직화학염색,분별검측조직중CXCL12/CXCR4、TopoⅡα、NF-κB단백수평。자술후개시수방,기록술후복발、전이、사망정황,사망환자이절미수거통계,존활환자지소수방3년,통계환자복발전이급사망솔,비교각조무병생존시간( DFS)。채용SPSS 17.0통계연건대수거진행분석,조간솔이급안불동림상병리지표분조후적비교균채용χ2검험화Fisher정학개솔법검험, DFS채용균수±표준차표시,조간비교채용배대양본적t검험。결과 TNBC조≤50세환자소점비례고、림파결전이교조、침윤성도관암、림상분기이Ⅲ기다견。 TNBC 조 CXCL12、CXCR4、TopoⅡα、NF?κB 양성세포비례분별위66.04%、84.91%、69.81%、79.25%,N?TNBC조비례분별위40.79%、51.32%、40.79%、51.32%,TNBC조양성세포비례고우N?TNBC조,차이유통계학의의(χ2=7.97,15.51,10.55,10.43;P<0.01)。 TNBC조복발전이솔、사망솔、DFS분별위20.75%、28.30%、(24.35±3.50)월,N?TNBC조분별위11.32%、13.16%、(32.02±4.00)월,TNBC조복발전이솔、사망솔균고우N?TNBC조,차이유통계학의의(χ2=4.51,4.58;P <0.05), DFS소우N?TNBC조( t =5.29, P<0.05);CXCL12、CXCR4、TopoⅡα、NF?κB양성표체조복발전이솔분별위19.70%、17.86%、19.12%、18.52%,음성표체조분별위6.35%、4.44%、6.56%、4.17%,양성표체조균고우음성표체조(χ2=5.02,4.61,4.43,5.43; P <0.05);양성표체조사망솔분별위27.27%、25.00%、26.47%、24.69%,음성표체조분별위11.11%、8.89%、11.48%、10.42%,양성표체조균고우음성표체조(χ2=5.39,4.87,4.63,3.93;P <0.05);양성표체조DFS분별위(23.17±3.30)월、(24.50±3.21)월、(23.51±3.65)월、(25.36±3.65)월,음성표체조분별위(32.25±3.55)월、(33.00±4.15)월、(35.00±5.10)월、(31.86±4.57)월,양성표체조균소우음성표체조( t =5.37,5.80,6.21,5.08;P <0.05)。결론 TNBC환자암조조직중CXCL12、CXCR4、TopoⅡα、NF?κB정고표체상태,차양성표체자복발전이교조,예후불가,저가능여기증가종류세포적침습능력、개도림파결특이성전이유관。
Objective To explore the meaning of the expression of CXCL12/CXCR4, Topo Ⅱα, NF?κB in tissues of triple negative breast carcinoma ( TNBC) . Methods Fifty?three cases with TNBC were enrolled as TNBC group, and seventy?six cases with non?triple negative breast carcinoma ( N?TNBC ) as N?TNBC group. Immunohistochemical stainings were conducted with resection specimens, and proteins of CXCL12/CXCR4,Topo Ⅱ α, NF?κB were detected. Patients were followed up after surgery to record postoperative recurrence,metastasis and death.The death cases were recorded by censored data,and surviving cases were followed up for 3 years at least. Rates of recurrence and metastasis, mortality, and disease free survival time (DFS) were compared among different groups.Results Less than or equal to 50 years old, lymph node metastasis,invasive ductal carcinoma and Ⅲ stage were TNBC patients′ main features. Positive cells of CXCL12,CXCR4,TopoⅡ α,NF?κB were 66.04%,84.91%,69.81%,79.25% respectively in TNBC group,and were 40.79%,51.32%,40.79%,51.32% in N?TNBC group.Positive cells of CXCL12,CXCR4, Topo Ⅱ α,NF?κB in TNBC group were all higher than those in N?TNBC group ( χ2=7.97,15.51,10.55, 10.43;P <0. 05 ) . Metastasis rate, mortality and DFS were 20. 75%, 28. 30%, ( 24. 35 ± 3. 50 ) months respectively in TNBC group,and were 11.32%,13.16%,(32.02±4.00)months in N?TNBC group.Metastasis rate,mortality in TNBC group were both greater than those in N?TNBC group ( χ2=4.51,4.58;P<0.05) ,yet DFS was less than that in N?TNBC group ( t=5.29, P<0.05).Rates of recurrence and metastasis in positive expression groups of CXCL12, CXCR4, Topo Ⅱ α, NF?κB were 19. 70%, 17. 86%, 19. 12%, 18. 52%, and were 6.35%,4.44%,6.56%,4.17% in negative expression groups,and they were all more significant than those in negative expression groups ( χ2=5.02,4.61,4.43,5.43;P<0.05).Mortality was 27.27%,25.00%, 26.47%,24. 69% in positive expression groups, and was 11. 11%, 8. 89%, 11. 48%, 10. 42% in negative expression groups, and they were all bigger than those in negative expression groups ( χ2=5.39,4.87,4.63, 3.93;P<0.05).DFS were (23.17±3.30)months, (24.50±3.21)months,(23.51±3.65)months,(25.36± 3.65)months in positive expression groups, and were(32.25±3.55)months,(33.00±4.15)months,(35.00± 5.10)months,(31.86±4.57)months in negative groups,and the differences between the two groups were statistically significant (t =5.37,5.80,6.21,5.08;P<0.05).Conclusion There are high expression of CXCL12,CXCR4, TopoⅡα,NF?κB in tissue of TNBC,with early recurrence and metastasis and poor prognosis,and it may be related with increasing tumor cells′invasive ability and mediating specific metastasis of lymph node.