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中华乳腺病杂志(电子版) ›› 2018, Vol. 12 ›› Issue (01) : 32 -36. doi: 10.3877/cma.j.issn.1674-0807.2018.01.007

所属专题: 文献

论著

E-钙黏蛋白及Ki67在三阴性乳腺癌中的表达及临床意义
杨海林1, 李涛1, 彭科1, 马小干1,()   
  1. 1. 400037 重庆,陆军军医大学新桥医院普通外科
  • 收稿日期:2017-06-07 出版日期:2018-02-01
  • 通信作者: 马小干

Expression of E-cadherin and Ki67 in triple negative breast cancer and clinical significance

Hailin Yang1, Tao Li1, Ke Peng1, Xiaogan Ma1,()   

  1. 1. Department of General Surgery, Xinqiao Hospital, Army Medical University, Chongqing 400037, China
  • Received:2017-06-07 Published:2018-02-01
  • Corresponding author: Xiaogan Ma
  • About author:
    Corresponding author: Ma Xiaogan, Email:
引用本文:

杨海林, 李涛, 彭科, 马小干. E-钙黏蛋白及Ki67在三阴性乳腺癌中的表达及临床意义[J/OL]. 中华乳腺病杂志(电子版), 2018, 12(01): 32-36.

Hailin Yang, Tao Li, Ke Peng, Xiaogan Ma. Expression of E-cadherin and Ki67 in triple negative breast cancer and clinical significance[J/OL]. Chinese Journal of Breast Disease(Electronic Edition), 2018, 12(01): 32-36.

目的

探讨E-钙黏蛋白、Ki67在三阴性乳腺癌(TNBC)中的表达及临床意义。

方法

回顾性分析陆军军医大学新桥医院2010年1月至2013年12月收治的77例女性TNBC患者临床资料。采用免疫组织化学方法检测E-钙黏蛋白和Ki67的表达情况,通过χ2检验分析其与患者临床病理资料的关系。由于77例患者中有5例失访,本研究仅对随访资料完整的72例患者采用Kaplan-Meier法、Log-rank检验、Cox逐步回归模型进行生存分析和危险因素分析。

结果

在77例患者中,E-钙黏蛋白的表达与淋巴结状态有关(χ2=16.428,P<0.001),而Ki67表达与组织学分级有关(χ2=7.218,P=0.007)。中位随访59个月,72例患者的DFS率和OS率分别为58.3%、68.1%。其中,E-钙黏蛋白高表达者DFS率和OS率均高于低表达者(DFS率:75.9%比46.5%,χ2=7.553,P=0.006;OS率:82.8%比58.1%,χ2=5.132,P=0.023),而Ki67低表达者DFS率和OS率均高于高表达者(DFS率:84.0%比44.7%,χ2=9.486,P=0.002;OS率:92.0%比55.3%,χ2=9.006,P=0.003)。Cox逐步回归模型分析显示,淋巴结转移、组织学分级高是患者DFS的独立危险因素(OR=4.030, 95%CI:1.854~8.757, P<0.001; OR=2.879,95%CI:1.359~6.100,P=0.006),Ki67高表达、淋巴结转移是OS的独立危险因素(OR=5.067,95%CI:1.179~21.768, P=0.029; OR=6.253,95%CI:2.296~17.034, P<0.001)。

结论

E-钙黏蛋白高表达和Ki67低表达的TNBC预后良好,这对于乳腺癌的个体化治疗具有一定的指导意义。

Objective

To investigate the expression of E-cadherin and Ki67 in triple negative breast cancer (TNBC) and explore its clinical significance.

Methods

We retrospectively analyzed the clinical data from 77 female patients with TNBC in our hospital from January 2010 to December 2013. Immunohistochemistry was adopted to detect the expression of E-cadherin and Ki67. The relationship of protein expression with clinicopathological characteristics was analyzed using χ2 test. Five cases were lost in the follow-up, so we analyzed the survival and risk factors in 72 patients using Kaplan-Meier method, Log-rank test and Cox stepwise regression model.

Results

In all 77 cases, the expression of E-cadherin was correlated with the status of lymph nodes (χ2=16.428, P<0.001), and the expression of Ki67 was correlated with histological grade (χ2=7.218, P=0.007). The median follow-up time was 59 months. In the 72 patients with complete follow-up data, the disease-free survival and overall survival were 58.3% and 68.1%, respectively. The disease-free survival and overall survival in high E-cadherin expression group was significantly higher than those in low E-cadherin expression group (DFS rate: 75.9% vs 46.5%, χ2=7.553, P=0.006; OS rate: 82.8% vs 58.1%, χ2=5.132, P=0.023). The disease-free survival and overall survival in low Ki67 expression group was significantly higher than those in high Ki67 expression group (DFS rate: 84.0% vs 44.7%, χ2=9.486, P=0.002; OS rate: 92.0% vs 55.3%, χ2=9.006, P=0.003). According to the Cox stepwise regression analysis, lymphnode metastasis and advanced histological grade were independent risk factors of disease-free survival (OR=4.030, 95%CI: 1.854-8.757, P<0.001; OR=2.879, 95%CI: 1.359-6.100, P=0.006), and high expression of Ki67 and lymphnode metastasis were independent risk factors of overall survival (OR=5.067, 95%CI: 1.179-21.768, P=0.029; OR=6.253, 95%CI: 2.296-17.034, P<0.001).

Conclusion

The TNBC patients with the high E-cadherin expression and low Ki67 expression have good prognosis, which can provide guidance for the individualized treatment of breast cancer.

表1 多因素Cox逐步回归模型分析变量赋值表
表2 77例三阴性乳腺癌患者临床病理资料与E-钙黏蛋白和Ki67表达的关系(例)
图1 72例三阴性乳腺癌组织中E-钙黏蛋白表达对患者无瘤生存率的影响
图2 72例三阴性乳腺癌组织中E-钙黏蛋白表达对患者总生存率的影响
图3 72例三阴性乳腺癌组织中Ki67表达对患者无瘤生存率的影响
图4 72例三阴性乳腺癌组织中Ki67表达对患者总生存率的影响
表3 72例三阴性乳腺癌复发影响因素的Cox逐步回归分析
表4 72例三阴性乳腺癌患者总生存影响因素的Cox逐步回归分析
[1]
Cleator S, Heller W, Coombes RC.Triple-negative breast cancer: therapeutic options [J].Lancet Oncol, 2007, 8(3): 235-244.
[2]
Yao H, He G, Yan S, et al. Triple-negative breast cancer: is there a treatment on the horizon? [J].Oncotarget, 2017, 8(1): 1913-1924.
[3]
Nakamoto K, Nagahara H, Maeda K, et al.Expression of E-cadherin and KRAS mutation may serve as biomarkers of cetuximab-based therapy in metastatic colorectal cancer [J]. Oncol Lett, 2013, 5 (4): 1295-1300.
[4]
邓淼,刘江波,刘起鹏,等.E-钙黏蛋白在乳腺癌组织中的表达及其临床意义[J/CD].中华乳腺病杂志(电子版),2015, 9(3):182-187.
[5]
Pathmanathan N, Balleine RL. Ki67 and proliferation in breast cancer[J]. J Clin Pathol, 2013, 66(6): 512-516.
[6]
王新昭,左文述,刘琪,等.2013年St Gallen乳腺癌会议国际专家共识荟萃[J].中华肿瘤防治杂志,2013,20(23):1859-1864.
[7]
中国抗癌协会乳腺癌专业委员会.中国抗癌协会乳腺癌诊治指南与规范(2015版)[J].中国癌症杂志,2015,25(9):692-754.
[8]
李世超,齐晓伟.美国临床肿瘤学会和美国病理学家学会乳腺癌雌激素/孕激素受体免疫组化检测指南[J/CD].中华乳腺病杂志(电子版),2011,5(3):385-387.
[9]
Lan C, Liu JM, Liu TW, et a1.erb-b2 amplification by fluorescence in situ hybridization in breast cancer specimens read as 2+ in immunohistochemical analysis[J].Am J Clin Pathol, 2005, 124 (1): 97-102.
[10]
Kashiwagi S, Yashiro M, Takashima T, et a1.Significance of E-cadherin expression in triple-negative breast cancer [J].Br J Cancer, 2010, 103 (2): 249-255.
[11]
Bianchini G, Balko JM, Mayer IA, et a1. Triple-negative breast cancer: challenges and opportunities of a heterogeneous disease[J]. Nat Rev Clin Oncol, 2016, 13(11): 674-690.
[12]
Adamo V, Ricciardi GR, De Placido S, et al. Management and treatment of triple-negative breast cancer patients from the NEMESI study: an Italian experience[J]. Eur J Cancer, 2012, 48(5): 642-647.
[13]
刘彦博.乳腺癌中E-钙黏素分子调节机制的研究进展[J].现代医药卫生,2014,30(8):1190-1192.
[14]
孔德娣.E-钙黏蛋白及三阴性表达与乳腺癌临床病理特征的关系[J].中华实用诊断与治疗杂志,2013,27(9):854-856.
[15]
Tashima R, Nishimura R, Osako T, et al. Evaluation of an optimal cut-off point for the Ki-67 index as a prognostic factor in primary breast cancer: a retrospective study [J]. PloS One, 2015, 10(7): e0119565.
[16]
Petrelli F, Viale G, Cabiddu M, et al. Prognostic value of different cut-off levels of Ki-67 in breast cancer: a systematic review and meta-analysis of 64 196 patients [J]. Breast Cancer Res Treat, 2015, 153(3): 477-491.
[17]
Nishimae A, Nakano Y, Nishi T, et al. Evaluation of pre-therapeutic Ki67 as a predictive marker for histological response to neoadjuvant therapy in breast cancer[J].Gan To Kagaku Ryoho, 2015, 42(12): 1491-1493.
[18]
Pan Y, Yuan Y, Liu G, et al. P53 and Ki-67 as prognostic markers in triple-negative breast cancer patients[J]. PLoS One, 2017, 12(2): e0172324.
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