ER、PR、HER-2和 Ki67在乳腺髓样癌中的表达及其临床意义

Expressions and clinical significances of ER，PR，HER-2 and Ki67 in human medullary carcinoma of the breast

摘要:

目的：探讨乳腺髓样癌（Medullary carcinoma of the breast，MBC）的雌激素受体（Estrogen receptor，ER）、孕激素受体（Progesterone receptor，PR）、人表皮生长因子受体-2（Human epidermal growth factor receptor-2，HER-2）和细胞增殖抗原Ki67表达情况及其临床意义。方法：收集43例临床病理资料完整的MBC病例，采用免疫组化S-P法检测癌组织中ER、PR、HER-2、Ki67 的表达情况并分析其结果，取同期的120例乳腺浸润性导管癌（Invasive ductal carcinoma，IDC）作对照研究。结果：免疫组化显示MBC组ER阳性率为8/43（18.75％），PR阳性率为11/43（25.58％），Her-2阳性率为14/43 （32.56％），Ki67阳性率为7/43（16.28%）。乳腺IDC中ER、PR、HER-2、Ki67的阳性率分别为25/120（20.83%）、33/120（27.50%）、49/120（40.83%）、42/120（35.00%）。Ki67的阳性率明显高于MBC组，差异有统计学意义（P<0.05）。Ki67的表达与患者的年龄、临床分期无显著相关性，而与肿瘤大小以及有无淋巴结转移有关（P<0.05）。MBC组织中Ki67表达强度与Her-2呈正相关性（r=0.447，P<0.05）；与ER和PR的表达无显著相关性（r=0.113和r=1.129，P >0.05）。结论：Ki67表达与乳腺癌发生、发展有关，可作为评价MBC发生、发展的生物学指标，联合ER、PR、HER-2检测有助于MBC预后的判断。

Abstract:

Objective：To investigate the expressions and clinical significances of estrogen receptor（ER），progesterone receptor（PR），human epidermal growth factor receptor-2（HER-2） and cell proliferative nuclear antigen Ki67 in human medullary carcinoma of the breast. Methods：The pathological data of 43 cases of medullary breast carcinoma（MBC） were collected. The expressions of ER，PR，HER-2 and Ki67 in carcinoma tissues in 43 cases were detected by immunohistochemical S-P method. Another 120 cases of invasive ductal carcinoma（IDC） of the breast were chosen as the controls. Results：The positive expression rates of ER，PR，HER-2 and Ki67 in MBC tissues were 8/43（18.75%），11/43（25.58%），14/43（32.56%），7/43（16.28%），respectively；meanwhile，the positive rates in IDC were 25/120（20.83%），33/120（27.50%），49/120 （40.83%），42/120（35.00%），respectively. The positive rate of Ki67 in IDC was significantly higher than that in MBC（P<0.05）. The positive expression of Ki67 was associated with tumor volume and lymph node metastasis（P<0.05），but not correlated with the age and clinical stage. There was a positive relationship between the expression of Ki67 and HER-2（r=0.447，P<0.05） and there was no relationship between the expression of Ki67 and PR and PR（r=0.113 and r=1.129，P >0.05）. Conclusions：The expression of Ki67 is correlated with the genesis，development of breast cancer，which can be con－sidered as a biological indicator in MBC. It will be useful for the prognosis through detecting the expression of Ki67 combined with ER，PR and HER-2.