论文部分内容阅读
目的:研究Ⅰ期乳腺癌p53、nm23和PCNA的表达,探讨其与预后的关系。方法:采用免疫组化S-P法检测138例Ⅰ期乳腺癌中p53、nm23、PCNA的表达。结果:p53阳性表达率为59.4%(82/138),其中髓样癌表达高于其它类型84.6%(11/13)。与病理类型、组织学分级无关(P>0.05),但与术后腋淋巴结转移密切相关(P<0.05)。淋巴结阳性p53与淋巴结阴性表达与生存期有明显差异(P<0.05)。nm23阳性表达率为82.6%(114/138),其中髓样癌、导管内癌100%表达(13/13、4/4),其次为导管癌早期浸润、管状腺癌、浸润性小叶癌、浸润性导管癌等,与病理类型、组织学分级相关,与腋淋巴结转移率呈负相关趋势,但无统计学差异(P>0.05)。PCNA阳性率为85.5%(118/138),PCNA平均指数为66.43±23.95,PCNA指数与组织学分级、淋巴结转移及预后有密切关系(P<0.01)。p53、nm23和PCNA协同表达观察结果显示,nm23与PCNA共同表达94例,且呈负相关;p53和PCNA共同表达37例,呈正相关;p53和nm23共同表达71例,且呈负相关;p53、nm23和PCNA协同表达62例,但与淋巴结转移及预后无关。结论:p53、nm23和PCNA在Ⅰ期乳腺癌有不同的表达,可作为反映Ⅰ期肿瘤增殖活性、侵袭力、预测预后的重要指标。为临床治疗提供参考依据。三者协同表达在肿瘤进展转移中的作用有待进一步研究。
Objective: To study the expression of p53, nm23 and PCNA in stage Ⅰ breast cancer and to explore its relationship with prognosis. Methods: The immunohistochemical S-P method was used to detect the expression of p53, nm23 and PCNA in 138 cases of stage Ⅰ breast cancer. Results: The positive rate of p53 was 59.4% (82/138). The expression of p53 in medullary carcinoma was higher than that in other types (84.6%, 11/13). It had no correlation with pathological type and histological grade (P> 0.05), but was closely related to axillary lymph node metastasis (P <0.05). Lymph node positive p53 and lymph node negative expression and survival were significantly different (P <0.05). The positive rate of nm23 expression was 82.6% (114/138), among them, medullary carcinoma and intraductal carcinoma were 100% (13/13, 4/4), followed by early invasive ductal carcinoma, tubular adenocarcinoma, infiltrating lobular carcinoma, Invasive ductal carcinoma and so on, which were correlated with pathological type and histological grade, but negatively correlated with axillary lymph node metastasis rate, but there was no significant difference (P> 0.05). The positive rate of PCNA was 85.5% (118/138) and the average PCNA index was 66.43 ± 23.95. There was a close relationship between PCNA index and histological grade, lymph node metastasis and prognosis (P <0.01). The results of co-expression of p53, nm23 and PCNA showed that 94 cases were negatively correlated with nm23 and PCNA, 37 cases were positive with p53 and PCNA, 71 cases were negative with p53 and nm23, 62 cases of nm23 and PCNA co-expression, but not lymph node metastasis and prognosis. Conclusion: The expressions of p53, nm23 and PCNA in stage Ⅰ breast cancer are different, which can be used as an important index to reflect the activity, invasiveness and prognosis of stage Ⅰ tumor. Provide a reference for clinical treatment. The role of the three coordinated expression in tumor progression and metastasis remains to be further studied.