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目的 :探讨p2 1WAF1、PCNA蛋白表达与乳腺癌预后的关系。方法 :以免疫组化S P法检测 15 2例乳腺癌组织p2 1WAF1和PCNA蛋白的表达水平。结果 :在 15 2例乳腺癌组织中 p2 1WAF1蛋白阳性 6 1例 (40 1% ) ,其中低表达 43例 (70 5 % ) ,高表达18例 (2 9 5 % ) ;6 9例 (45 % )PCNA低指数表达 ,83例 (5 5 % )PCNA高指数表达 ;p2 1WAF1蛋白的表达与乳腺癌组织腺管形成(γs=0 34 1,P <0 0 1)、细胞核多型 (γs=0 5 16 ,P <0 0 1)、核分裂象计数 (γs=0 35 1,P <0 0 1)和组织学分级 (γs=0 415 ,P <0 0 1)呈正相关 ;单因素预后分析显示 p2 1WAF1蛋白高表达组生存期低于低表达组 (χ2 =6 92 ,P <0 0 1) ,PCNA高指数表达组生存期短于低指数表达组 (χ2 =5 14,P <0 0 5 ) ,p2 1WAF1- /PCNA低指数表达组 ,p2 1WAF1+/PCNA低指数组 ,p2 1WAF1+/PCNA高指数组和p2 1WAF1- /PCNA高指数组生存期依次减少 (χ2 =11 0 7,P <0 0 1)。结论 :(1)p2 1WAF1/PCNA的联合检测有利于更准确地判断细胞增殖活性和预后 ;(2 ) p2 1WAF1在乳腺癌中的不同表达水平可能与不同的调控方向有关。
Objective : To investigate the relationship between p21WAF1 and PCNA protein expression and the prognosis of breast cancer. Methods: The expression of p21WAF1 and PCNA protein in breast cancer tissues was detected by immunohistochemical SP method. RESULTS: The p21WAF1 protein was positive in 61 (40 1%) of the 152 breast cancers, of which 43 (70.5%) were lowly expressed and 18 (25.5%) were highly expressed; 69 (45) %) PCNA low-index expression, 83 cases (55%) PCNA high-index expression; p2 1WAF1 protein expression and breast cancer tissue duct formation (γs = 0 34 1, P <0 01), nuclear polymorphism (γs There was a positive correlation between mitotic counts (γs=035 1, P <0 01) and histological grade (γs=0 415, P <0.01); univariate prognosis was statistically significant (P < 0.01). Analysis showed that the survival time of p21WAF1 protein high expression group was lower than that of low expression group (χ2=6 92, P <0 01). The survival index of PCNA high index expression group was shorter than that of low index expression group (χ2=5 14, P <0. 0 5), p2 1WAF1-/PCNA low index expression group, p2 1WAF1+/PCNA low index group, p2 1WAF1+/PCNA high index group and p2 1WAF1-/PCNA high index group had a shorter survival time (χ2=11 0 7,P <0 0 1). Conclusion : (1) The combined detection of p2 1WAF1/PCNA is helpful for judging the cell proliferation activity and prognosis more accurately. (2) The different expression levels of p2 1WAF1 in breast cancer may be related to different regulation directions.