PTEN蛋白和E-cadherin在乳腺癌组织中的表达及其临床意义

doi:10.3760/cma.j.issn.1673-422X.2019.01.002

摘要/Abstract

摘要： 目的探讨人第10号染色体缺失的磷酸酶及张力蛋白同源（PTEN）蛋白和上皮钙黏着蛋白（E-cadherin）在乳腺癌组织中的表达及其临床意义。方法回顾性分析哈尔滨医科大学附属第一医院2012年11月至2014年12月收治的263例乳腺癌患者临床资料，采用免疫组织化学方法检测PTEN蛋白及E-cadherin的表达情况，运用χ2检验或Fisher确切概率法分析两者表达与临床病理特征的关系，PTEN蛋白与E-cadherin之间的关系采用列联相关分析，通过KaplanMeier生存分析方法分析两者的表达与乳腺癌患者预后的情况，采用COX比例风险模型进行危险因素分析。结果 PTEN蛋白和E-cadherin在乳腺癌组织中的阳性表达率分别为68.4%（180/263）和95.4%（251/263），低于其在癌旁乳腺组织中的表达77.9%（205/263）和98.5%（259/263），差异有统计学意义（χ2=6.056，P=0.014；χ2=4.125，P=0.042）。PTEN蛋白的表达与淋巴结转移和临床分期有关（χ2=8.443，P=0.015；χ2=9.253，P=0.010），E-cadherin的表达与年龄、绝经状态、肿瘤最大径、淋巴结转移及临床分期均无关（均P>0.05）。列联相关分析显示，PTEN蛋白与Ecadherin在乳腺癌组织中的表达呈正相关（C=0.125，P=0.041）。生存分析显示，PTEN蛋白阴性表达患者的5年无瘤生存率为81.9%，低于阳性表达患者的95.0%（χ2=12.040，P=0.001）；E-cadherin阴性表达患者的5年无瘤生存率为66.7%，低于阳性表达患者的92.0%（χ2=13.313，P<0.001）。COX回归多因素分析显示PTEN蛋白及Ecadherin阴性表达、淋巴结转移是乳腺癌患者预后的独立危险因素（HR=2.554，95%CI为1.016~6.420，P=0.046；HR=3.573，95%CI为1.136~11.239，P=0.029；HR=3.622，95%CI为2.026~6.476，P<0.001）。结论 PTEN蛋白与E-cadherin表达相关且两者低表达可能是乳腺癌发生发展、侵袭转移的机制之一，联合检测可作为判断乳腺癌预后情况的指标之一。

关键词: 乳腺肿瘤, PTEN磷酸水解酶, 钙黏着糖蛋白类, 预后

Abstract: Objective To investigate the expressions of phosphatase and tensin homologue deleted on chromosome ten (PTEN) and epithelial cadherin (E-cadherin) in breast cancer tissues and explore their clinical significance. MethodsWe retrospectively analyzed the clinical data of 263 breast cancer patients admitted to the First Affiliated Hospital of Harbin Medical University from November 2012 to December 2014. The expressions of PTEN and E-cadherin were detected by immunohistochemistry. The relationship of protein expression with clinicopathological characteristics was analyzed by χ2 test or Fisher exact test. Contingency correlation analysis was used to analyze the correlation between PTEN and E-cadherin, and KaplanMeier was used to evaluate the relationship between their expressions and patients′ survival. COX regression model was used to analyze risk factors. ResultsThe positive expression rates of PTEN and Ecadherin in breast cancer tissues were 68.4% (180/263) and 95.4% (251/263) respectively, lower than those in paratumor breast tissues 77.9% (205/263) and 98.5% (259/263), with statistically significant differences (χ2=6.056, P=0.014; χ2=4.125, P=0.042). PTEN expression was associated with lymph node metastasis (χ2=8.443, P=0.015) and clinical stage (χ2=9.253, P=0.010). Ecadherin expression was not correlated with age, menopausal status, tumor maximum diameter, lymph node metastasis and clinical stage (all P>0.05). Contingency correlation analysis showed a positive correlation between PTEN and Ecadherin expressions in breast cancer tissues (C=0.125, P=0.041). Survival analysis showed that the 5 year tumorfree survival rate was 81.9% in the PTEN negative group, lower than 95.0% in the positive group (χ2=12.040, P=0.001). The 5year tumorfree survival rate in the E-cadherin negative group was 66.7%, lower than 92.0% in the positive group (χ2=13.313, P<0.001). COX multivariate analysis showed that negative expressions of PTEN and E-cadherin and lymph node metastasis were independent risk factors for the prognosis of breast cancer patients (HR=2.554, 95%CI: 1.0166.420, P=0.046; HR=3.573, 95%CI: 1.13611.239, P=0.029; HR=3.622, 95%CI: 2.0266.476, P＜0.001). Conclusion PTEN is related to Ecadherin expression and low expressions of both may be one of the mechanisms of breast cancer development, invasion and metastasis. Combined detection can be used as an indicator to determine the prognosis of breast cancer.

Key words: Breast neoplasms, PTEN phosphohydrolase, Cadherins, Prognosis

陈一鸣,周毅. PTEN蛋白和E-cadherin在乳腺癌组织中的表达及其临床意义[J]. 国际肿瘤学杂志, 2019, 46(1): 6-10.

Chen Yiming, Zhou Yi. Expressions of PTEN and E-cadherin in breast cancer tissues and their clinical significance[J]. Journal of International Oncology, 2019, 46(1): 6-10.

参考文献

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