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目的 :探讨乳腺癌组织中组织蛋白酶D(Cath -D)表达与雌激素受体 (ER)水平的相关性和联合检测对预测乳腺癌病人生存率的意义。方法 :采用免疫组化S -P法检测 138例腋淋巴结阳性乳腺癌病人Cath -D和ER的表达 ,结合随访材料进行统计学分析。结果 :本组 5年无瘤生存率 6 0 .9% (84 138) ;Cath -D在癌细胞中的表达阳性率 5 5 .1% ,ER表达阳性率 5 1.4 %。Cath -D和ER表达阳性率呈负相关 (r=- 0 .2 94 ,P =0 .0 0 1)。在临床分期Ⅲ期、淋巴结转移数目≥ 10个及出现复发转移的病例中 ,Cath -D表达阳性率显著增高 (χ2 =13.92 6 ,P =0 .0 0 0 ;χ2 =13.0 70 ,P=0 .0 1;χ2 =10 .5 4 5 ,P =0 .0 0 1) ,而Cath -D表达阳性率与年龄和病理学类型无关。ER阳性而Cath -D阴性病人5年无瘤生存率最高 ,但ER阴性、Cath -D阳性时则相反 (χ2 =18.6 75 ,P =0 .0 0 0 )。结论 :ER和Cath -D检测相结合 ,可更好地反映腋淋巴结阳性乳腺癌组织的生物学特性 ,对判断乳腺癌病人的预后可能更有实际意义。
Objective: To investigate the correlation between the expression of cathepsin D (Cath-D) and the level of estrogen receptor (ER) in breast cancer and the significance of the combined detection in predicting the survival rate of patients with breast cancer. Methods: The expression of Cath-D and ER in 138 cases of axillary lymph node positive breast cancer was detected by immunohistochemical S-P method. The follow-up materials were used for statistical analysis. Results: The 5-year tumor-free survival rate was 60.9% (84 138). The positive expression rate of Cath-D in cancer cells was 51.5% and the positive expression rate of ER was 51.4%. Cath-D and ER expression was negatively correlated (r = - 0.224, P = 0.010). The positive rate of Cath-D expression was significantly higher in the stage of clinical stage Ⅲ, the number of lymph node metastasis ≥ 10 and the recurrence and metastasis (χ2 = 13.92 6, P = 0.000; χ2 = 13.070, P = 0 .0 1; χ2 = 10 .5 4 5, P = 0.0001), while the positive rate of Cath-D expression was not related to the age and pathological type. The 5-year disease-free survival was highest in ER-positive and Cath-D-negative patients, but negative in ER and negative in Cath-D (χ2 = 18.6 75, P = .0 0 0). Conclusion: The combination of ER and Cath-D test can better reflect the biological characteristics of axillary lymph node positive breast cancer tissue, and may be more practical for judging the prognosis of patients with breast cancer.