c-erbB-2基因在乳腺浸润性导管癌及腋窝转移淋巴结中表达相关性.doc

c-erbB-2基因在乳腺浸润性导管癌及腋窝转移淋巴结中表达相关性 　 作者：王晔　宋科瑛　王建丰　仇生龙　项富海　李克 【摘要】 目的：探讨乳腺浸润性导管癌中c-erbB-2的表达及其与腋窝淋巴结等临床病理因素的相关性。方法：采用免疫组织化学方法检测149例乳腺浸润性导管癌患者乳腺原发灶及47例腋淋巴结转移灶中c-erbB-2的表达，结合临床病理因素，分析其相关性。结果：19.46%(29/149)原发灶c-erbB-2高表达，其表达水平与肿瘤大小、腋窝淋巴结转移情况呈正相关，与ER、PR表达呈负相关。47例腋窝淋巴结转移乳腺浸润性导管癌患者中，原发灶c-erbB-2高表达18例(38.30%)，腋窝淋巴结转移灶c-erbB-2高表达16例(34.04%)，两者差异无统计学意义(Pgt;0.05)。5例原发灶c-erbB-2阴性或低表达患者腋窝淋巴结转移呈高表达，7例原发灶c-erbB-2高表达患者淋巴结转移呈阴性或低表达，变化率为25.53%(12/47)。结论: c-erbB-2可以作为预测乳腺癌预后的指标，指导术后治疗，但应当考虑c-erbB-2在原发灶和复发转移灶之间的差异，有必要对复发转移灶进行c-erbB-2检测。 【关键词】 乳腺肿瘤·癌基因，c-erbB-2·肿瘤转移 　　【ABSTRACT】 Objective：To observe the expression of c-erbB-2 and its relationship with clinical and pathological characteristics in infiltrating ductal breast cancer. Methods： Immunohistochemical technique was performed to detect the expression of oncogene c-erbB-2 in 149 cases of primary carcinoma and 47 cases of synchronous metastatic lymph node. Their clinical and pathological indices and follow up data were analyzed. Results： The overexpression rate of c-erbB-2 was 19.46%(29/149). The expression of c-erbB-2 was significantly correlated with the tumor size, the expression of ER and PR and lymph node metastasis (Plt;0.05), but not with the age (Pgt;0.05). 12 of 47 cases (25.53%) showed a discordance of c-erbB-2 status between primary carcinoma and synchronous lymph node metastases. Conclusion：The expression of c-erbB-2 gene is positively correlated with tumor invasion ,axillary lymphatic metastasis and negatively correlated with the expression of ER and PR in breast cancer. c-erbB-2 can be used as an independent molecular marker for determining the prognosis and planning the postoperative treatment. For the treatment of metastatic patients, the evaluation of c-erbB-2 status should be performed in neoplastic tissue from metastatic site, whenever possible. 　　【KEY WORDS】 Breast Neoplasms·Oncogene,c-erbB-2·Neoplasm metastasis 　　乳腺癌是女性最常见的恶性肿瘤之一，近年来其发病率不断上升，其死亡原因大都是远处转移。c-erbB-2基因是人类表皮生长因子受体(epidermal growth factor receptor，E