影响乳腺癌雌激素受体表达临床病理因素分析.docVIP

影响乳腺癌雌激素受体表达临床病理因素分析 　 作者：郝静 王秀梅 衣翠华 于学军 张昕 扈东艳 李明 于金明 【摘要】目的：探讨影响乳腺癌雌激素受体（ER）表达的临床病理因素。方法：利用免疫组织化学方法检测76例乳腺癌组织中ER和Ki67、CerbB2及HIF1α的表达，并与临床病理资料进行相关性分析。结果：ER、Ki67、CerbB2及HIF1α在乳腺癌组织中的阳性率分别为67.1%、39.5%、31.6%和54.0%。ER表达与Ki67、CerbB2及HIF1α呈负相关（P＜0.05），与癌组织高分化成正相关（P＜0.05），而与年龄、腋窝淋巴结转移、肿瘤大小及组织学类型无显著相关。结论：乳腺癌组织中Ki67、CerbB2及HIF1α等的高表达可能参与了降低ER表达及原发性内分泌治疗抵抗的发生。 【关键词】乳腺肿瘤#12539;受体，雌激素#12539;Ki67#12539;基因，CerbB2#12539;乏氧诱导因子1α Analysis of clinicopathological factors which influence the expression of estrogen receptor in breast carcinoma 【ABSTRACT】Objective:To investigate the clinicopathological parameters which influence the expression of estrogen receptor(ER)in breast carcinomas.Methods:The expression of ER together with progesterone receptor(PR),Ki67,CerbB2 and hypoxia inducible factor1α (HIF1α)were assessed by immunohistochemistry in 76 cases of breast carcinoma,and their correlation with the other clinicopathological factors were also analyzed.Results:ER,Ki67,CerbB2 and HIF1α staining were observed in 67.1%,39.5%,31.6% and 54.0% respectively.ER status was inversely correlated with expression of Ki67,CerbB2 and HIF1α.Besides,ER status had a positive correlation with high differentiation (P＜0.05).However,it was not related to any other clinicopathological characteristic,such as age,axillary lymph node metastasis,tumor size and histology.Conclusion:High expression of Ki67,CerbB2 and HIF1αmay play important roles in downregulation of ER and therefore the development of primary endocrine therapy resistance. 【KEY WORDS】Breast neoplasms#12539;Receptors,estrogen#12539;Ki67#12539;Genes,CerbB2#12539;Hypoxia inducible factor1 乳腺癌为雌激素依赖性肿瘤，抗雌激素治疗疗效主要决定于雌激素受体（estrogen receptor,ER）的表达情况。大约一半ER阳性的晚期乳腺癌患者可迅速对三苯氧胺等抗雌激素药物产生耐药，其原因除ER表达缺失外，ER与其它生长因子途径存在着交互作用，导致乳腺癌细胞可不依赖于ER表达情况生长增殖，成为构成获得性耐药的重要原因［1］。本研究通过对76例乳腺癌组织同时进行ER、细胞增殖核抗原（Ki67）、CerbB2及乏氧诱导因子1α（HIF1α）免疫组化检测，探讨影响乳腺癌ER表达的临床病理因素和抗雌激素治疗抵抗的可能原因。 1 材料与方法 1.1 临床资料 乳腺癌76例，手术切除并经病理学确诊，术前均未接受放化疗。浸润性导管癌60例，导管内癌6例，浸润性小叶癌10例。年龄29~82岁，平均（51.8±10.