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目的探讨三种热休克蛋白(HSPs:HSP27、HSP70、HSP90α)在乳腺癌中的表达,评估其在乳腺癌预后中所起的作用。方法用免疫组织化学方法检测78例手术切除的乳腺癌组织中HSPs的表达,研究其与临床病理特征的关系及对预后的影响。结果 HSP27、HSP70、HSP90α在乳腺癌组织中的阳性表达率分别为38.5%、53.8%和30.8%。除HSP70表达与肿瘤大小及腋窝淋巴结转移个数存在相关性外(P<0.05),HSP27与HSP90α表达同各临床病理特征之间的相关性均不具有统计学意义(P>0.05)。HSP70、HSP90α阴性表达组的无病生存期(DFS)及总生存期(OS)均明显优于各自的阳性表达组(P<0.05);而HSP27阴性表达组与阳性表达组病人的DFS、OS差异无统计学意义(P>0.05)。Cox回归多因素分析表明仅有腋窝淋巴结转移个数、HSP90α表达、组织学分级及肿瘤大小与DFS及OS明显相关,HSP90α阳性表达有减少DFS及OS的危险;而TNM分期、HSP70阳性表达未进入Cox回归模型。结论三种热休克蛋白在乳腺癌组织中有一定程度的表达,HSP70和HSP90α阳性表达与乳腺癌患者生存期的缩短有关,HSP90α阳性表达为乳腺癌预后高危险因素,可作为独立预后评估指标。
Objective To investigate the expression of three heat shock proteins (HSP27, HSP70, HSP90α) in breast cancer and evaluate their roles in the prognosis of breast cancer. Methods Immunohistochemical method was used to detect the expression of HSPs in 78 surgically resected breast cancers and its relationship with clinicopathological features and prognosis. Results The positive rates of HSP27, HSP70 and HSP90α in breast cancer tissues were 38.5%, 53.8% and 30.8% respectively. There was no correlation between the expression of HSP70 and the size of tumor and the number of axillary lymph node metastasis (P <0.05). The correlation between the expression of HSP27 and HSP90α and clinicopathological features was not statistically significant (P> 0.05). The disease-free survival (DFS) and overall survival (OS) of HSP70 and HSP90α negative expression groups were significantly better than those of the positive expression groups (P <0.05), while the positive rates of DFS and OS of HSP27 negative expression group The difference was not statistically significant (P> 0.05). Cox regression multivariate analysis showed that only the number of axillary lymph node metastasis, HSP90α expression, histological grade and tumor size were significantly correlated with DFS and OS, and the positive expression of HSP90α could reduce the risk of DFS and OS. However, TNM stage and HSP70 expression did not Cox regression model. Conclusion The three heat shock proteins are expressed in breast cancer to some extent. The positive expression of HSP70 and HSP90α is related to the shortened survival of patients with breast cancer. The positive expression of HSP90α is a high risk factor of breast cancer prognosis, which can be used as an independent prognostic index.