国际肿瘤学杂志

国际肿瘤学杂志 ›› 2016, Vol. 43 ›› Issue (10): 728-732.doi: 10.3760/cma.j.issn.1673-422X.2016.10.002

• 论著 • 上一篇    下一篇

Luminal型乳腺癌P53表达与临床病理特征及预后的关系

宋方彬,李善宝,张建兵,吴珺艺,金涛,秦钧,王晔,王敏,徐军明   

  1. 200080 上海交通大学附属第一人民医院普外科（宋方彬、李善宝、吴珺艺、金涛、秦钧、王晔、王敏、徐军明），病理科（张建兵）
  • 出版日期:2016-10-08 发布日期:2016-09-07

Correlations between P53 expression and clinicopathologic factors and the prognosis of Luminal breast cancer

Song Fangbin, Li Shanbao, Zhang Jianbing, Wu Junyi, Jin Tao, Qin Jun, Wang Ye, Wang Min, Xu Junming   

  1. Department of General Surgery, Shanghai General Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200080, China
  • Online:2016-10-08 Published:2016-09-07
  • Contact: 徐军明 E-mail:xujmsh@hotmail.com

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摘要： 目的探讨Luminal型乳腺癌P53表达与临床病理特征及预后的关系。方法选取2009年1月至2012年12月在上海交通大学附属第一人民医院手术治疗的283例Luminal型乳腺癌患者作为研究对象，采用免疫组织化学法测定P53表达。生存分析采用KaplanMeier曲线评估和Logrank检验比较，并用Cox比例风险回归模型进行单因素和多因素分析。结果Luminal型乳腺癌患者P53表达与肿瘤最大径（χ2=6.285，P=0.043）、淋巴结转移（χ2=15.881，P=0.000）、组织分级（χ2=8.132，P=0.043）、Ki67（χ2=6.476，P=0.039）有关；而与年龄（χ2=0.955，P=0.328）、月经状态（χ2=3.808，P=0.051）、病理类型（χ2=0.847，P=0.655）、雌激素受体（χ2=1.867，P=0.172）、孕激素受体（χ2=0.937，P=0.333）及人表皮生长因子受体2（χ2=0.110，P=0.741）无关。在283例患者中，P53阴性组和阳性组5年无复发生存率分别为90.7%、66.7%（χ2=12.609，P=0.000），5年总生存率分别为93.4%、84.4%（χ2=4.153，P=0.042），差异均有统计学意义。Cox多因素分析发现，淋巴结转移（HR=2.484，95%CI为1.393～4.431，χ2=9.497，P=0.002）和P53阳性（HR=3.627，95%CI为1.061～12.401；χ2=4.220，P=0.040）是Luminal型乳腺癌患者无复发生存的独立危险因素；淋巴结转移（HR=3.451，95%CI为1.891～6.297；χ2=16.290，P=0.000）和高组织学分级（HR=2.806，95%CI为1.091～7.219；χ2=4.582，P=0.032）是总生存时间的独立危险因素。结论Luminal型乳腺癌患者P53过表达与淋巴结转移、组织分级等预后因素相关，且P53过表达患者预后更差。

关键词: 基因, p53, 预后, 乳腺肿瘤, Luminal型

Abstract: ObjectiveTo investigate the correlations between P53 expression and clinicopathologic factors and prognosis of Luminal breast cancer. MethodsFrom January 2009 to December 2012, a total of 283 patients with Luminal breast cancer in the Shanghai General Hospital Affiliated to Shanghai Jiaotong University were included. P53 expressions of them were assayed by immunohistochemistry. Survival analysis was applied using KaplanMeier curve and Logrank test. Single factor analysis and mutiplefactor analysis were applied using Cox proportional hazard regression model. ResultsThe rate of P53 expression was associated with tumor size (χ2=6.285, P=0.043), lymph node metastasis (χ2=15.881, P=0.000), histological grade (χ2=8.132, P=0.043) and Ki67 (χ2=6.476, P=0.039), but it was not associated with age (χ2=0.955, P=0.328), menopausal status (χ2=3.808, P=0.051), pathological pattern (χ2=0.847, P=0.655), estrogen receptor (χ2=1.867, P=0.172), progesterone receptor (χ2=0.937, P=0.333) and human epidermal growth factor receptor2 (χ2=0.110, P=0.741). In all the 283 patients, the 5year relapsefree survival rates for P53positive group and P53negative group were 66.7% and 90.7% respectively (χ2=12.609, P=0.000), while the 5year overall survival rates were 84.4% and 93.4% respectively (χ2=4.153, P=0.042), with significant differences. In Cox mutiplefactor analysis, lymph node metastasis (HR=2.484, 95%CI: 1.3934.431, χ2=9.497, P=0.002) and P53 overexpression (HR=3.627, 95%CI: 1.06112.401, χ2=4.220, P=0.040) were independent prognostic factors for the relapsefree survival of patients with Luminal breast cancer, and lymph node metastasis (HR=3.451, 95%CI: 1.8916.297, χ2=16.290, P=0.000) and higher histological grade (HR=2.806, 95%CI: 1.0917.219, χ2=4.582, P=0.032) were independent prognostic factors for overall survival. ConclusionP53 overexpression of patients with Luminal breast cancer is associated with prognostic factors such as lymph node metastasis and histological grade, which indicates the worse prognosis.

Key words: Genes, p53, Prognosis, Breast neoplasms, Luminal subtype