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目的:探讨骨唾液蛋白(BSP)和甲状旁腺相关蛋白(PTHrP)的联合检测对乳腺癌骨转移的临床意义。方法:乳腺癌87例患者,分为骨转移组40例和无骨转移组47例。应用免疫组织化学法检测石蜡包埋标本BSP和PTHrP的表达。结果:BSP和PTHrP在骨转移组的阳性表达均明显高于无骨转移组(χ2值分别为8.47和10.49,P均<0.01),且强阳性表达也均高于后者(χ2值分别为9.18和11.05,P均<0.05);同时两者在骨转移组的阳性表达与无转移组和骨外转移组之间比较,差异有统计学意义(P<0.01),而后两组间阳性表达差异无统计学意义(P>0.05)。Cox比例风险回归模型分析结果发现,乳腺癌组织中BSP和PTHrP的高表达是预测骨转移的主要危险因素(P<0.01),其相对危险度分别为1.293和1.348。Log-rank生存曲线分析结果显示,在乳腺癌患者中BSP和PTHrP高表达者的累积生存概率均明显低于BSP和PTHrP阴性表达组,P<0.05。结论:BSP和PTHrP的过表达是早期预测乳腺癌骨转移的良好标志,并可作为评估乳腺患者的一项重要的预后因子。
Objective: To investigate the clinical significance of the combined detection of bone sialoprotein (BSP) and parathyroid related protein (PTHrP) in the bone metastasis of breast cancer. Methods: 87 patients with breast cancer were divided into 40 cases of bone metastasis and 47 cases of boneless metastasis. Immunohistochemistry was used to detect the expression of BSP and PTHrP in paraffin-embedded specimens. Results: The positive expressions of BSP and PTHrP in bone metastasis group were significantly higher than those in non-bone metastasis group (χ2 = 8.47 and 10.49, P <0.01, respectively), and strong positive expression was also higher than the latter (χ2 = 9.18 and 11.05 respectively, P <0.05). At the same time, there was a significant difference between the two groups in the positive expression of bone metastasis group and the no metastasis group and the bone metastasis group (P <0.01) The difference was not statistically significant (P> 0.05). Cox regression analysis showed that the high expression of BSP and PTHrP in breast cancer was the main risk factor for predicting bone metastasis (P <0.01), with relative risk of 1.293 and 1.348, respectively. Log-rank survival curve analysis showed that in patients with breast cancer BSP and PTHrP high expression of the cumulative survival rate was significantly lower than BSP and PTHrP negative expression group, P <0.05. CONCLUSION: Overexpression of BSP and PTHrP is a good marker for early prediction of bone metastasis in breast cancer and may be an important prognostic factor for evaluating breast cancer patients.