目的 探讨表皮生长因子受体(epidermal growth factor receptor, EGFR)与B淋巴细胞瘤-2基因(B-cell lymphoma-2, Bcl-2)在乳腺癌中的表达状况及其临床意义。方法 采用免疫组化(二步法)实验方法检测539例乳腺癌组织雌激素受体(estrogen receptor, ER)、孕激素受体(progesterone receptor, PR)、人表皮生长因子受体2(human epidermal growth factor receptor-2,HER-2)以及EGFR、Bcl-2的表达。结果 EGFR的表达以三阴性乳腺癌最高 (44.4%);Bcl-2的表达以管腔型乳腺癌最高(71.7%)。在EGFR的表达上,三阴性乳腺癌与管腔型乳腺癌(χ2=9.02, P<0.05)、HER-2受体阳性组乳腺癌患者(χ2=5.78, P<0.05)相比表达率更高;在Bcl-2表达上,管腔型乳腺癌与HER-2受体阳性组乳腺癌(χ2=70.73, P<0.0001)、三阴性乳腺癌(χ2=71.76, P<0.0001)的患者相比表达率更高。两者的表达与其他病理特征的差异均无统计学意义。乳腺癌组织学分级越高EGFR的阳性表达率越高(χ2=11.38,P<0.05),而Bcl-2的阳性表达率越低(χ2=6.92, P<0.05)。PR、Bcl-2与ER表达呈正相关,相关系数分别为0.712、0.599,差异有统计学意义(P<0.01)。同时,PR与Bcl-2间也呈正相关关系(r=0.599,P<0.01)。而ER、PR分别与HER-2、EGFR之间以及HER-2与Bcl-2之间都呈负相关,它们的相关系数依次为-0.366、-0.133、-0.453、-0.195和-0.392。结论 EGFR与Bcl-2的表达在乳腺癌不同分子亚型间存在差异; EGFR以及Bcl-2的表达可以作为乳腺癌发生、发展的评价指标,有助于评估乳腺癌的生物学行为并指导临床治疗以及制定预后策略。
Abstract
Objective To study the expression of epidermal growth factor receptor (EGFR) and B-cell lymphoma-2 (Bcl-2) in breast cancer subtype and their relationship with clinicopathological features and the expression of ER,PR and HER-2. Methods Immunohistochemistry was performed to detect the expression of EGFR and Bcl-2 in 539 patients with breast cancer and its correlation with clinicopathological parameters was analyzed. Results The expression rate of EGFR in three negative breast cancer group (χ2=9.78,P=0.008) and Bcl-2 in luminal breast cancer group (χ2=114.11, P<0.0001) were 44.4% and 71.7%, which were the highest in all groups. The expression of EGFR showed a statistically significant difference in histological grade (χ2=11.38,P=0.003), and the expression of Bcl-2 showed a statistically significant difference in histological grade (χ2=6.92, P=0.041) and pathological type (χ2=5.39,P=0.022). No significant difference was found between the expression of both and other clinicopathological features. The expression of PR and Bcl-2 was positively correlated with the expression of Bcl-2, and their correlation coefficients were 0.712(P<0.01) and 0.599(P<0.01), respectively, which was the same with the expression between PR and Bcl-2 (r=0.599,P<0.01). However, there was a negative correlation between ER,PR and HER-2, Bcl-2 respectively, and their correlation coefficient were -0.366,-0.133,-0.453,-0.392 successively. In addition, no correlation was found between EGFR and HER-2, Bcl-2 (P>0.05). Conclusions The expression of EGFR and Bcl-2 is different in breast cancer subtypes. Joint detection of the expression of EGFR and Bcl-2 could be used as index of breast cancer occurrence, development, and help to guide clinical treatment and prognosis of strategy.
关键词
EGFR /
Bcl-2 /
乳腺癌 /
临床病理特征
Key words
EGFR /
Bcl-2 /
breast cancer /
clinicopathological features
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基金
国家科技支撑计划项目(SQ2015BA1300692);北京自然科学基金(7132027)
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