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目的研究新辅助化疗前后浸润性乳腺癌中醛糖还原酶(AKR1B1)、人表皮生长因子受体-2(HER-2)、雌激素受体(ER)、孕激素受体(PR)蛋白表达的变化及相关性,分析AKR1B1、HER-2、ER、PR的表达与淋巴结转移之间的相关性。方法收集2010年1月-2012年12月在该院接受新辅助化疗治疗的浸润性乳腺癌患者40例,用免疫组织化学法检测患者新辅助化疗前后及淋巴结转移灶中AKR1B1、HER-2、ER、PR蛋白的表达情况,HER-2(2+)患者用显色原位杂交(CISH)法检测HER-2扩增情况。结果患者新辅助化疗前AKR1B1阳性表达率高于化疗后,差异有统计学意义(P<0.05);化疗前ER(+)、PR(+)阳性表达率为42.5%,ER(+)、PR(+)患者中AKR1B1阳性表达率为47.1%,化疗后ER(+)、PR(+)阳性表达率为37.5%,ER(+)、PR(+)、AKR1B1化疗前后比较,差异无统计学意义(P>0.05),淋巴结转移率为23.5%;ER(-)、PR(-)者中AKR1B1阳性表达率为80.0%,与ER(+)、PR(+)组比较,差异有统计学意义(P<0.05);淋巴结转移率为60.0%,与ER(+)、PR(+)组比较,差异有统计学意义(P<0.05);ER(-)、PR(-)患者化疗后AKR1B1(+)表达率为25.0%,化疗前后比较差异有统计学意义(P<0.01),淋巴结转移灶中均有AKR1B1的表达;化疗后AKR1B1(+)转为(-)的病例中ER或者PR的表达呈增高趋势,HER-2的表达呈降低趋势;其中AKR1B1(+)、ER(-)、PR(-)、HER-2(3+)的病例淋巴结转移率为83.3%。结论浸润性乳腺癌中AKR1B1与ER、PR的表达呈负相关,与HER-2的表达及淋巴结转移呈正相关;新辅助化疗可导致AKR1B1、ER、PR、HER-2蛋白的表达发生改变,AKR1B1与HER-2的改变呈正相关,与ER、PR的改变呈负相关;因此,联合检测AKR1B1、ER、PR、HER-2的表达对预测乳腺癌发生、发展、转移、治疗效果及预后有提示作用。
Objective To study the expression of aldose reductase (AKR1B1), human epidermal growth factor receptor-2 (HER-2), estrogen receptor (ER) and progesterone receptor (PR) in invasive breast cancer before and after neoadjuvant chemotherapy The correlation between the expression of AKR1B1, HER-2, ER, PR and lymph node metastasis was analyzed. Methods Forty infiltrating breast cancer patients who underwent neoadjuvant chemotherapy in our hospital from January 2010 to December 2012 were enrolled in this study. AKR1B1 and HER-2 levels were measured by immunohistochemical staining before and after neoadjuvant chemotherapy and lymph node metastasis. ER, PR protein expression, HER-2 (2+) patients with chromogenic in situ hybridization (CISH) detection of HER-2 amplification. Results The positive rate of AKR1B1 in patients before neoadjuvant chemotherapy was significantly higher than that in patients with chemotherapy (P <0.05). The positive rate of ER (+) and PR (+) before chemotherapy was 42.5% The positive rate of AKR1B1 was (47.1%) in patients with (+) and 37.5% of patients with ER (+) and PR (+) after chemotherapy (P> 0.05). The positive rate of AKR1B1 in ER (-) and PR (-) was 80.0%. The difference between the two groups was statistically significant (P <0.05). The rate of lymph node metastasis was 60.0%, which was significantly different from that of ER (+) and PR (+) groups The expression of AKR1B1 (+) was 25.0%, there was significant difference between before and after chemotherapy (P <0.01), and the expression of AKR1B1 in lymph node metastasis. After ERK1B1 (+ The expression of PR was increased and the expression of HER-2 was decreased. The rate of lymph node metastasis in patients with AKR1B1 (+), ER (-), PR (-) and HER-2 (3+) was 83.3%. Conclusions The expression of AKR1B1 in ERCC is negatively correlated with the expression of ER and PR in invasive breast cancer and positively correlated with the expression of HER-2 and lymph node metastasis. The neoadjuvant chemotherapy can change the expression of AKR1B1, ER, PR and HER-2, while AKR1B1 Which is positively correlated with the change of HER-2 and negatively correlated with the changes of ER and PR. Therefore, the combined detection of AKR1B1, ER, PR and HER-2 may be helpful to predict the occurrence, development, metastasis, therapeutic effect and prognosis of breast cancer effect.