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目的观察分析乳腺癌增强斜率与癌基因表达的关系,探讨乳腺癌增强斜率大小的分子生物学基础,为临床治疗和预后判断提供新方法。方法对行MR动态增强扫描并经病理证实的58例乳腺癌患者的病理切片,行ER、PR及P53、CerbB-2、血管内皮生长因子(VEGF)及微血管密度(MVD)免疫组织化学检测,分析最大斜率与ER、PR及P53、CerbB-2、VEGF及MVD的相关性。结果 (1)增强扫描最大斜率与ER、PR呈负相关(r=-0.09,-0.17),与P53、CerbB-2的表达呈正相关(r=0.10,0.07),但均无统计学意义(P>0.05);(2)P53表达与ER、PR呈负相关(r=-0.26,-0.28),有统计学意义(P<0.05),提示P53高表达则预后不良;(3)MVD与VEGF表达呈正相关(r=0.39,P<0.05),动态增强扫描最大斜率与VEGF明显相关(r=0.63,P<0.01),但最大斜率与MVD无明显相关(r=0.08,P>0.05)。结论增强扫描最大斜率与VEGF表达有关,与MVD无明显相关性,提示恶性肿瘤斜率增高的分子生物学基础是血管内皮细胞不完整,通透性增加,而与血管密度无明显关系。临床上可根据增强扫描最大斜率的高低判断VEGF表达程度,从而判断预后并指导抗血管生成药物的选择,也可根据最大斜率的变化进行疗效判定。
Objective To observe and analyze the relationship between the enhanced slope of breast cancer and the expression of oncogenes, and to explore the molecular biology basis of the enhanced slope of breast cancer and to provide a new method for clinical treatment and prognosis. Methods Immunohistochemical detection of ER, PR, P53, CerbB-2, VEGF and MVD was performed in pathological sections of 58 cases of breast cancer with MR dynamic contrast-enhanced scan. The correlation between maximum slope and ER, PR and P53, CerbB-2, VEGF and MVD was analyzed. Results (1) The maximum slope of enhanced scan was negatively correlated with ER and PR (r = -0.09, -0.17) and positively correlated with the expression of P53 and CerbB-2 (r = 0.10,0.07) P <0.05). (2) There was a negative correlation between P53 expression and ER and PR (r = -0.26, -0.28) (P <0.05), suggesting that P53 overexpression had a poor prognosis. (3) (R = 0.39, P <0.05). The maximal slope of dynamic enhanced scan correlated with VEGF (r = 0.63, P <0.01), but the maximum slope had no significant correlation with MVD (r = . Conclusions The maximum slope of enhanced scan is related to the expression of VEGF and has no obvious correlation with MVD, suggesting that the molecular biology of malignant tumors with increased slope is the incomplete vascular endothelial cells with increased permeability but not with the vascular density. Clinically, the level of VEGF expression can be judged according to the maximum slope of enhancement scan to judge the prognosis and guide the choice of anti-angiogenic drugs. The curative effect can also be determined according to the change of maximum slope.