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

doi:10.3877/cma.j.issn.1674-0807.2018.01.007

Abstract

Abstract:

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.

Key words: Breast neoplasms, Ki-67 antigen, E-cadherin

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

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Figures/Tables 8

References 18

[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.

因素	变量名	赋值
年龄(岁)	X1	>40＝0，≤40＝1
肿瘤大小(cm)	X2	>2＝0，≤2＝1
月经状态	X3	绝经＝0，未绝经＝1
组织学分级	X4	2级＝0，3级＝1
淋巴结状态	X5	无淋巴结转移＝0，淋巴结转移＝1
E-钙黏蛋白	X6	高表达＝0，低表达＝1
Ki67	X7	<20%＝0，≥20%＝1
复发转移情况	Y1	无复发、转移＝0，有复发、转移＝1
生存情况	Y2	存活＝0，死亡＝1

因素	变量名	赋值
年龄(岁)	X1	>40＝0，≤40＝1
肿瘤大小(cm)	X2	>2＝0，≤2＝1
月经状态	X3	绝经＝0，未绝经＝1
组织学分级	X4	2级＝0，3级＝1
淋巴结状态	X5	无淋巴结转移＝0，淋巴结转移＝1
E-钙黏蛋白	X6	高表达＝0，低表达＝1
Ki67	X7	<20%＝0，≥20%＝1
复发转移情况	Y1	无复发、转移＝0，有复发、转移＝1
生存情况	Y2	存活＝0，死亡＝1

临床病理特征		例数	E-钙黏蛋白		χ²	P值	Ki67		χ²	P值
临床病理特征		例数	低表达	高表达	χ²	P值	低表达	高表达	χ²	P值
年龄		?	?	?	?	?	?	?	?	?
?	≤40岁	18	13	5	1.235	0.266	5	13	0.377	0.539
?	>40岁	59	34	25	1.235	0.266	21	38	0.377	0.539
淋巴结转移		?	?	?	?	?	?	?	?	?
?	阴性	42	17	25	16.428	<0.001	18	24	3.414	0.065
?	阳性	35	30	5	16.428	<0.001	8	27	3.414	0.065
组织学分级		?	?	?	?	?	?	?	?	?
?	2级	46	25	21	2.151	0.142	21	25	7.218	0.007
?	3级	31	22	9	2.151	0.142	5	26	7.218	0.007
肿瘤大小		?	?	?	?	?	?	?	?	?
?	≤2 cm	16	9	7	0.195	0.659	5	11	0.057	0.811
?	>2 cm	61	38	23	0.195	0.659	21	40	0.057	0.811
月经状态		?	?	?	?	?	?	?	?	?
?	未绝经	42	27	15	0.410	0.522	14	28	0.008	0.930
?	绝经	35	20	15	0.410	0.522	12	23	0.008	0.930

临床病理特征		例数	E-钙黏蛋白		χ²	P值	Ki67		χ²	P值
临床病理特征		例数	低表达	高表达	χ²	P值	低表达	高表达	χ²	P值
年龄		?	?	?	?	?	?	?	?	?
?	≤40岁	18	13	5	1.235	0.266	5	13	0.377	0.539
?	>40岁	59	34	25	1.235	0.266	21	38	0.377	0.539
淋巴结转移		?	?	?	?	?	?	?	?	?
?	阴性	42	17	25	16.428	<0.001	18	24	3.414	0.065
?	阳性	35	30	5	16.428	<0.001	8	27	3.414	0.065
组织学分级		?	?	?	?	?	?	?	?	?
?	2级	46	25	21	2.151	0.142	21	25	7.218	0.007
?	3级	31	22	9	2.151	0.142	5	26	7.218	0.007
肿瘤大小		?	?	?	?	?	?	?	?	?
?	≤2 cm	16	9	7	0.195	0.659	5	11	0.057	0.811
?	>2 cm	61	38	23	0.195	0.659	21	40	0.057	0.811
月经状态		?	?	?	?	?	?	?	?	?
?	未绝经	42	27	15	0.410	0.522	14	28	0.008	0.930
?	绝经	35	20	15	0.410	0.522	12	23	0.008	0.930

因素		回归系数	标准误	Wald值	P值	OR值	95%CI
步骤1		?	?	?	?	?	?
?	淋巴结	1.474	0.391	14.218	<0.001	4.368	2.030～9.398
步骤2		?	?	?	?	?	?
?	淋巴结	1.394	0.396	12.386	<0.001	4.030	1.854～8.757
?	组织学分级	1.058	0.383	7.625	0.006	2.879	1.359～6.100

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