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目的:探讨绝经前乳腺癌患者肿瘤组织中AIB-1蛋白表达与他莫昔芬耐药关系。方法:选取2004年1月至2004年12月河北医科大学第四医院外一科手术切除并经病理证实、且随访资料完整的绝经前女性原发性乳腺癌206例,按照免疫组化检测结果分成:ER+/PR+且接受他莫昔芬治疗组(Tamoxifen group,T组),ER-PR-的非内分泌治疗组(Contol group,C组);T组及C组均按AIB-1及Her-2表达状态分为不同亚组。采用Kaplan-Meier法分析各组别无病生存(disease-free survival,DFS)及总生存(overallsurvival,OS)时间。结果:术后随访30～84个月,中位时间65个月,58例患者出现局部复发或远位转移,5年DFS为71.84%(148/206);死亡36例,5年OS为82.52%(170/206)。随着组织学分级、腋淋巴结阳性及Her-2蛋白表达的增高,AIB-1蛋白呈现高表达(x~2=12.573,P=0.002;x~2=7.939,P=0.005;x~2=4.502,P=0.036);分层分析中,T组AIB-1及Her-2均高表达亚组的DFS和OS低于其他亚组,且有统计学差异(x~2=5.900,P=0.002;x~2=4.533,P=0.049);该亚组患者的生存曲线明显低于其他亚组患者(Log-rank检验,x~2=8.903,P=0.005;x~2=9.405,P=0.004)。结论:AIB-1蛋白高表达常常伴随着不良的临床生物学行为和预后,AIB-1蛋白高表达、同时伴有Her-2高表达的绝经前乳腺癌患者对他莫昔芬治疗耐药,提示AIB-1的表达可以作为预测他莫昔芬耐药的因子。
Aims: To investigate the relationship between AIB-1 protein expression and tamoxifen resistance in premenopausal breast cancer patients. Methods: 206 cases of primary breast cancer in premenopausal women with surgically resected and confirmed by pathology and complete follow-up data from January 2004 to December 2004 in the Fourth Hospital of Hebei Medical University were enrolled. According to the results of immunohistochemistry The patients were divided into two groups: ER + / PR + and received Tamoxifen group (T group) and ER-PR- group (Contol group, C group) -2 expression status is divided into different subgroups. Kaplan-Meier method was used to analyze the disease-free survival (DFS) and overall survival time (OS) of each group. Results: The follow-up was 30-84 months with a median time of 65 months. Fifty-eight patients had local recurrence or distant metastasis. The 5-year DFS was 71.84% (148/206), 36 died and the 5-year OS was 82.52 % (170/206). AIB-1 protein was highly expressed with histological grade, axillary lymph node positive and Her-2 protein expression (x ~ 2 = 12.573, P = 0.002; 4.502, P = 0.036). In the stratified analysis, the DFS and OS in high expression subgroup AIB-1 and Her-2 in group T were lower than those in other subgroups, and there was a significant difference (x 2 = 5.900, P = (P = 0.002; P = 0.049; P = 0.049, P = 0.049). The survival curves of this subgroup were significantly lower than those of other subgroups (Log-rank test, x2 = 8.903, P = 0.005; = 0.004). Conclusion: The high expression of AIB-1 protein is often associated with poor clinical biological behavior and prognosis. AIB-1 protein is overexpressed. Meanwhile, patients with pre-and post-menopausal Her-2 overexpression of Her-2 are resistant to tamoxifen, It is suggested that the expression of AIB-1 can be used as a predictor of tamoxifen resistance.